Application of the best evidence for preventing central venous catheter-related thrombosis in patients undergoing continuous renal replacement therapy.

This was a single-centre before-and-after, non-synchronous control study that compared calendar periods, so other differences between the periods may have contributed. The supplied text does not describe randomisation or blinding. The program included several components at once: evidence selection, standardised catheter sealing and locking, risk-stratified heparin concentrations, urokinase thrombolysis, nurse training, dynamic monitoring, and review indicators. The paper does not show which component produced the change. The nurse knowledge questionnaire was developed by the study team, was measured after training using a self-controlled pre-and-post design, and the paper does not report follow-up after the training period. Four review indicators did not reach 90% compliance, and the authors attribute this to staffing constraints and electronic medical record limitations. The reported CRT incidence uses catheter patency evaluations as the denominator, not a per-patient count.

The authors declared no competing interests. The supplied text credits some authors with funding acquisition but does not name a funder.

Do not read the fall from 28.46% to 15.33% as proof that one catheter-locking step prevented thrombosis. The study changed many things at once, including evidence review, standardised catheter sealing and locking, risk-stratified heparin concentrations, urokinase thrombolysis, nurse training, dynamic monitoring, and review indicators. It was a before-after, non-synchronous control study, so the contribution of any single component cannot be separated.