Impact of Indwelling Pleural Catheter specific educational tools on unplanned hospital encounters and caregiver training

Indwelling pleural catheters (IPCs) are an effective treatment for symptomatic malignant pleural effusions. However, IPCs require resources for caregiver training (CGT) and are associated with complications which may result in unplanned hospital encounters (UHE). We sought to determine if IPC-specific educational tools may reduce UHEs and improve CGT outcomes in IPC care. Using a quality improvement model, we introduced an instructional video and user guide for IPC care as educational adjuncts for CGT and monitored the incidence of UHEs, survey scores on caregiver knowledge and confidence and IPC complication rates pre- and post-intervention. A total of 166 patients were included in this study, with 72 in the pre-intervention and 94 in the intervention group. Data on UHEs and survey scores was available for 22 patients in the pre-intervention, and for all patients in the intervention group. There was a significantly lower proportion of patients who had ≥1 UHE in the intervention (8.5% vs 45.5%, p<0.001) group. There was no difference in IPC duration (68 (IQR:42-134) vs 58 (IQR:31-98) days, p=0.159), but a trend towards an increase in the number of days-to-complication in the intervention group (45 (IQR:20-64) vs 28 (IQR:4-47), p=0.096). Caregiver knowledge scores were also higher in the intervention group (100.0% (IQR:86-100%) vs 71.4% (IQR:57-86%), p<0.001). There was no difference in time required for CGT (80 (IQR:45-108) vs 90 (IQR: 60-117) minutes, p=0.140), and IPC complication rates (27.7% vs 25.1%, p=0.640) between the pre-intervention and intervention groups respectively. The use of IPC-specific educational tools in CGT are associated with reduced UHEs.