Effect of Ventricular Assist Device Self-care Simulation-Based Mastery Learning on Driveline Exit Site Infections: A Pilot Study.
Jane E Wilcox, Rebecca S Harap, Valentina Stosor and 11 others
PMID 34091567WHAT IT FOUND
VAD self-care simulation training for patients and caregivers did not significantly reduce driveline exit-site infections at 12 months compared with usual training.
Key findings
01In the mastery-learning group, no infections were observed at 3 months and 2 were observed at 12 months; in the usual-training group, 6 infections were observed at 3 months and no additional infections were observed by 12 months.
02The between-group difference in time to infection did not reach statistical significance (p=0.07).
03In exploratory analysis, sex was associated with time to infection (p=0.02), with estimated 12-month infection-free probability .887 for males and .577 for females.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was single centre, so the training may not transfer to other institutions. The infection outcome was an exploratory aim, and the trial was not powered to detect differences in driveline exit-site infections. There were few infection events, and one more infection could have changed the results. Two patient-caregiver pairs in each group were lost to follow-up.
Declared interests
NIH extramural support is listed. Dr. Wilcox receives consulting honoraria from Boehringer Ingelheim and Medtronic and serves on the scientific advisory board for Cytokinetics; the other authors report no relevant conflicts.
The easy way to misread this
Do not conclude that simulation-based mastery learning reduces driveline exit-site infections. The training was a multi-component bundle, the infection comparison was exploratory, the study was not powered for it, and the between-group difference did not reach statistical significance (p=0.07).