P5 Methodology: A Novel Multidisciplinary Strategy to Improve Non-Hemodialysis Vascular Access Outcomes

Background: A methodology (P5) which includes a review of the promise, people, process, policy and products, was developed as a comprehensive quality improvement tool. The tool was implemented for non-hemodialysis midline and peripherally inserted central line catheters to identify opportunities for infection prevention performance improvement related to outcomes for patients in an acute care hospital.

Methods: The methods used were a comprehensive review, the setting of multiple goals for measures of success through the comparison of vascular access devices from two leading device manufacturers. The measures were a reduction in central line-associated bloodstream infections, use of tPA and triple lumen catheters.

Results: The successful implementation of P5 resulted in surpassing all measures including 98% reduction in triple lumen use, 100% reduction in additional midline usage for initiation of therapy, 96% reduction in tPA, and 53% reduction in central line-associated bloodstream infections.

Conclusion: The change in product was noted as a catalyst. The sustainability of the reductions was attributed to the successful implementation of the P5 methodology. Further research is needed to determine the applicability outside the non-hemodialysis vascular access scope.


Jennifer Sanguinet

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