Efficacy and safety of a two-step method of skin preparation for peripheral intravenous catheter insertion: a prospective multi-centre randomised trial

We have developed a two-step procedure for preparing the skin before peripheral venous catheter (PVC) insertions. This procedure involves two successive swabbings with wipes soaked in alcoholic antiseptic. We investigated whether this two-step procedure was as effective and safe as the standard four-step procedure – washing with detergent, rinsing, drying, applying antiseptic – by carrying out a multicentre randomised equivalence study comparing the frequency of precursor signs of infection at the site of insertion for the two skin preparation procedures. The study was carried out over an eight-month period, and 248 PVC insertion sites were evaluated. The two-step procedure was used for 130 subjects and the standard procedure for 118. Taking into account all the confounding factors predisposing patients to the complications studied, the characteristics of the two groups of patients were found to be similar, with no significant differences noted. The incidence of precursor signs of infection was 11 % 24 hours after PVC insertion (27/248), 25 % at 48 hours (50/203) and at 29 % at 72 hours (34/119). Eleven patients had complications necessitating the withdrawal of the PVC: sensitivity of the insertion site, with redness and/or slight swelling and/or a palpable venous cord. No major complications were observed in this study. The frequency of local complications associated with PVCs reported in this study, whether simple or severe, was not affected by the skin preparation procedure used for PVC insertion (two-step or four-step procedure)

La formation des professionnels de la santé dans le système scolaire du Québec

Vol. 1. La main-d'oeuvre hospitalière -- v. 2. Structure occupationnelle de la main-d'oeuvre dans les hôpitaux du Québec -- v. 3. Étude économique de la main-d'oeuvre hospitalière : pénuries et surplus -- v. 4. Analyse des mécanismes existant dans la solution des problèmes de relations de travail -- v. 5. Budget global et main-d'oeuvre hospitalière -- v. 6. Main-d'oeuvre hospitalière et changements technologiques -- v. 7. Obstacles juridiques à la mobilité de la main-d'oeuvre hospitalière -- v. 8. La formation des professionnels de la santé dans le système scolaire du Québe