Keywords

infection, patient simulation, patient-centered care, self-care, ventricular assist device

Authors

1. Wilcox, Jane E. MD, MS
2. Harap, Rebecca S. BSN
3. Stosor, Valentina MD
4. Cohen, Elaine R. MEd
5. Grady, Kathleen L. PhD, RN
6. Cameron, Kenzie A. PhD, MPH
7. Scholtens, Denise M. PhD
8. Wayne, Diane B. MD
9. Shanklin, Kerry B. MSN, FNP
10. Nonog, Gretchen P. BSN
11. Schulze, Lauren E. MSN, FNP
12. Jirak, Alison M. BSN
13. Magliola, Grace C. BSN, RN-BC
14. Barsuk, Jeffrey H. MD, MS

Abstract

Background: Ventricular assist device simulation-based mastery learning (SBML) results in better patient and caregiver self-care skills compared with usual training.

Objective: The aim of this study was to evaluate the effect of SBML on driveline exit site infections.

Methods: We compared the probability of remaining infection free at 3 and 12 months between patients randomized to SBML or usual training.

Results: The SBML-training group had no infections at 3 months and 2 infections at 12 months, yielding a Kaplan-Meier estimate of the probability of remaining infection free of 0.857 (95% confidence interval [CI], 0.692-1.00) at 12 months. The usual-training group had 6 infections at 3 months with no additional infections by 12 months. Kaplan-Meier estimates of remaining infection free at 3 and 12 months were 0.878 (95% CI, 0.758-1.00) and 0.748 (95% CI, 0.591-0.946), respectively. Time-to-infection distributions for SBML versus usual training showed a difference in 12-month infection rates of 0.109 (P = .07).

Conclusions: Ventricular assist device self-care SBML resulted in fewer 12-month infections.