Factors associated with variability in management of vascular access ports

Abstract

Guidelines and clinical practice recommendations vary on the management of vascular access ports. Traditionally, patient, health system and healthcare professional's factors have been interrelated in studies of clinical practice variability. Understanding variation in the management of vascular access ports and to identify the influence of these factors in the compliance with the most common recommendations of vascular access guidelines, is an important first step for designing targeted improvement interventions. We analysed data from a survey sent to all Spanish outpatient clinics. Overall, 185 units at Spanish outpatients clinics out of a total of 256 completed the survey. Geographical region and unit size are the most common associated factors in the management of vascular access ports and there is a low level of compliance with many of the recommendations given by guidelines. Large outpatient chemotherapy units have been related to higher monitoring of the recommendations. Clinical practice and provided care to patients with vascular access ports are influenced by region and structural and organisational differences in the outpatient chemotherapy units. It is important to identify additional factors that may explain the variability.