Effectiveness of a Web-based Module to Improve Infection Prevention Knowledge for Hospitalists Performing Central Venous Catheter Insertion

 

Background: The emerging specialty of Hospital Medicine is playing an increasing role in the prevention of central line associated blood stream infection (CLABSI), yet little in known about effective interventions targeted to this specialty.

Objective:   To assess baseline knowledge of CVC insertion IP practices and a web based module's effectiveness in durably improving a hospital medicine group's knowledge and attitudes concerning CVC insertion and IP practices.

Methods:   In this urban, academic safety-net hospital, the Hospitalist Medicine group is comprised of physicians (MD), physician assistants (PA), and nurse practitioners (NP).  All PAs and NPs rotate through the procedure service while only 5 of the 23 MDs are proceduralists.  All hospitalists were invited to participate in a web-based training module aimed at improving CVC insertion IP knowledge.  Training was conducted in two phases.  In phase 1, participants completed a pre and post-test 1 to assess immediate impact of the training.  Phase 2 occurred two months after the close of Phase 1.  Retention of training knowledge was assessed in Phase 2 with a repeat of the post-test.

 

Results:   A total of 36 Hospitalists participated in the voluntary CVC insertion web-based training.  For the group as a whole, a repeated measures one-way ANOVA revealed significant differences between the three testing periods, p<0.000.  LSD comparisons revealed that all three means were significantly different from each other.  Mean test score was significantly higher immediately after training (M=82.0) than before training (M=60.3). The mean test score two months later was significantly lower (M=69.6) than immediately after the training, but significantly higher than the mean test score before training.  Pearson correlation revealed time spent completing the training (M=32 minutes) had no effect on test scores:  post test 1 (r=-0.227, p=0.183) and post test 2 (r=-0.227, p=0.212).  There was also no correlation between provider type and test score:  post test 1 (r=0.006, p=0.972) and post test 2 (r=-0.080, p=0.662). 

 

 

Conclusions:   Web based training targeted to Hospital Medicine attending physicians improves awareness of best practices for preventing infections. Length of time since training negatively affects knowledge retention but still demonstrated increased knowledge compared to baseline.