Oncology nurses' knowledge of guidelines for preventing catheter-related bloodstream infections

Assessment of Knowledge, Attitude, and Adherence to National Guidelines for Preventing Central Line-Associated Bloodstream Infections Among ICU Nurses of Adult Patients in Jeddah, Saudi Arabia: A Cross-Sectional Survey

BACKGROUND

Central line-associated bloodstream infections (CLABSIs) pose a significant burden on patient outcomes in intensive care units (ICUs). Adherence to evidence-based guidelines for CLABSI prevention is crucial in reducing healthcare-associated infections. This study aimed to assess the knowledge, attitude, and practice adherence to national guidelines for preventing CLABSIs among adult ICU nurses in Ministry of Health (MOH) hospitals in Jeddah, Saudi Arabia.  Methods: This cross-sectional survey included all adult ICU nurses with a minimum of one year of experience from the four major MOH hospitals in Jeddah with operational adult ICUs. A self-administered online questionnaire was utilized for data collection. Descriptive statistics, t-tests, ANOVA, and Pearson correlation were employed for data analysis.  Results: A total of 203 nurses completed the questionnaire (response rate: 91.5%). The overall knowledge score was 71%. Only 20% of nurses answered over 90% of the knowledge questions correctly, and merely 8% answered all questions correctly. Higher knowledge levels were significantly associated with older age, longer ICU nursing experience, higher education, holding a head nurse position, and attending educational courses on CLABSI prevention. Regarding attitudes, 58% of respondents had a positive perception of guideline utility for CLABSI prevention. In terms of adherence, the overall score was 65%, with only 5% reporting complete adherence to evidence-based practices for preventing CLABSIs.  Conclusion: This study highlights knowledge gaps, suboptimal adherence, and the need for targeted interventions to enhance nurses' understanding of and adherence to evidence-based guidelines for preventing CLABSIs among adult ICU nurses in Jeddah's MOH hospitals. Enhancing knowledge, attitudes, and practice adherence is crucial for reducing CLABSI risks and improving patient outcomes. Further research investigating the factors influencing nurses' knowledge, acceptance, and application of evidence-based guidelines is warranted to inform the development of tailored interventions and educational strategies.

Cuidados de enfermería para reducir infecciones por microorganismos oportunistas en pacientes oncológicos

Introducción: las infecciones generadas por microorganismos oportunistas (MO) o infecciones oportunistas (IO) son causa importante de morbimortalidad en pacientes oncológicos y se les atribuyen factores relacionados con los cuidados específicos de la atención en salud. Las alteraciones en el sistema inmunológico, la multirresistencia antimicrobiana, la neutropenia febril y la interrupción de la integridad cutánea son los factores más influyentes. Objetivo: describir las principales intervenciones y estrategias para reducir IO en pacientes oncológicos. Metodología: revisión integrativa de la literatura. Se incluyeron artículos en español, inglés y portugués indexados a los tesauros MeSH Y DeCS, en las bases de datos CINAHL, Nursing Ovid, Clinicalkey; el metabuscador de Google académico y la interfaz Pubmed. Resultados: se revisaron 56 estudios, fueron organizados en tres temáticas: factores de riesgo que influyen para adquirir una IO en pacientes oncológicos, infecciones por MO y cuidados de enfermería, los cuales se agruparon en subtemas como: educación, medidas estándar, de barrera, farmacológicas, nutrición, manejo de catéteres, cavidad bucal, piel y aspectos emocionales. Discusión: se evidencian factores que influyen en la no adherencia por parte de los profesionales que están relacionados con sus posturas, el contexto social, el sistema sanitario y características de las GPC. Conclusión: fue posible describir las intervenciones y estrategias de prevención que permiten reducir de manera importante la morbimortalidad en pacientes oncológicos.

Assessment of Knowledge on the Prevention of Central-Line-Associated Bloodstream Infections among Intensive Care Nurses in Poland-A Prospective Multicentre Study

The presence of a central venous catheter (CVC) leads to a high risk of blood infections, which are considered major causes of morbidity, mortality and high medical costs. The aim of this study was to assess the knowledge of nursing staff working in intensive care units (ICUs) regarding the prevention of central-line-associated bloodstream infections (CLABSIs). A nationwide survey was conducted among ICU nurses from August 2016 to April 2017. A modified Polish version of the questionnaire developed by Labeau et al. was used to assess the nurses' knowledge. Of the 750 questionnaires distributed, 468 were returned. Women accounted for 95.73% of all respondents, and over 80% were university educated. Most of the nurses surveyed (85.9%) had previously received training in CVC guidelines, and thus over 82% rated their knowledge as good or very good. The guidelines introduced in hospitals were the main declared sources of information. In addition, more than half (68%) of respondents also knew the international guidelines. The knowledge of nursing staff in the study area is not sufficient. Studies show that the guidelines for the prevention of CLABSIs in ICUs should be standardized, and continuous training of personnel in this field should be provided.

Paediatric nurses', children's and parents' adherence to infection prevention and control and knowledge of antimicrobial stewardship: A systematic review

INTRODUCTION

Infection prevention and control precautions help to decrease microbial transmission, and through the appropriate use of antibiotics, Antimicrobial Stewardship programs aim to decrease the prevalence and emergence of Antimicrobial Resistance.

METHODS

A systematic review was undertaken to critically appraise and synthesise evidence for nurses', children's and parents' knowledge and understanding of antimicrobial stewardship, and of infection prevention and control in acute paediatric care settings. The Preferred Reporting Items for Systematic reviews and Meta-Analyses guided the review. Studies were included if they examined the factors that contributed to nurses' adherence to, or consumers' practice in relation to, antimicrobial stewardship and infection prevention and control.

RESULTS

Of the 16,957 papers identified, 50 studies conducted in acute paediatric settings met the eligibility criteria, and were included. Most studies were of low methodological quality. Fourteen studies evaluated nurses' knowledge and self-reported adherence to Infection Prevention and Control principles and identified consistent practice gaps by nurses. Six studies evaluating the effectiveness of education programs reported modest improvements in nurses' knowledge and adherence to infection prevention and control. There were 15 studies, that investigated consumers' involvement in infection prevention and control that identified the following themes: Consumer knowledge and attitudes to infection prevention and control and transmission-based precautions, and parents' willingness to take an active role in infection prevention. Six studies focused on paediatric nurses' role in antimicrobial stewardship, exploring the following themes: (1) nurses' understanding and beliefs of antimicrobial stewardship roles, and (2) barriers to nurses taking a greater role in antimicrobial stewardship. Nine studies explored the role of consumers in antimicrobial stewardship and identified consumers' misconceptions about the benefits and downplayed concerns regarding antibiotic use.

DISCUSSION

Although consumers articulated a willingness to be actively involved in infection prevention, observed practice remained lower than that required to consistently prevent infection transmission.

CONCLUSION

These findings highlight a critically important gap in current practice. In relation to optimal use of antimicrobials, although paediatric nurses were involved in supporting antimicrobial stewardship processes and educating consumers, they identified limited antimicrobial stewardship knowledge. Consumers appeared to lack understanding about the benefits of antibiotics and negated concerns regarding antibiotic use.

Nurses and physicians knowledge of guidelines for preventing catheter-related blood stream infections

BACKGROUND

Catheter-related blood stream infection (CRBSI) is considered a major challenge for health care providers working in intensive care units.

AIM

This study aimed to evaluate and compare the knowledge of evidence-based guidelines for preventing catheter-related blood Stream infections among physicians and nurses working in critical care units in Jordan.

DESIGN

A cross-sectional survey design was utilized.

METHODS

The study was conducted in five intensive care units; 181 nurses and 68 physicians were recruited from four governmental hospitals and one university-affiliated hospital.

RESULTS

The mean total knowledge score for physicians' knowledge was low at 2.6, SD 1.5 (out of 10). While the mean total score for nurses' knowledge was low at 3.3, SD 1.8 (out of 10). The independent t test shows that nurses had a significantly higher mean total knowledge score than physicians (P < .05).

CONCLUSIONS

The current study demonstrates that Jordanian nurses and physicians working in intensive care units have a low level of knowledge of the guidelines for preventing CRBSI. This problem should be addressed through routine assessment and evaluation and adoption and policies that make nurses and physicians comply with the evidence-based guidelines. Finally, conducting regular educational programmes on CRBSI prevention, and evaluation of compliance with the guidelines in daily clinical practice, are strongly recommended.

RELEVANCE TO CLINICAL PRACTICE

The results of the current study suggest the need for regular assessment of physicians' and nurses' knowledge and skills with regard to central venous catheter insertion and maintenance care. Based on this assessment and using the best available evidence, training programmes on the prevention of CRBSI should be developed. Courses might be online, face to face, or using high fidelity simulation. Finally, regular observation and evaluation of compliance with the CRBSI guidelines in daily clinical practice is needed.

Prevention of central line-associated bloodstream infections: a survey of ICU nurses' knowledge and practice in China

Background

Central line-associated bloodstream infections (CLABSI) are largely preventable when evidence-based guidelines are followed. However, it is not clear how well these guidelines are followed in intensive care units (ICUs) in China. This study aimed to evaluate Chinese ICU nurses’ knowledge and practice of evidence-based guidelines for prevention of CLABSIs issued by the Centers for Disease Control and Prevention, US and the Department of Health UK.

Method

Nurses completed online questionnaires regarding their knowledge and practice of evidence-based guidelines for the prevention of CLABSIs from June to July 2019. The questionnaire consisted of 11 questions, and a score of 1 was given for a correct answer (total score = 0–11).

Results

A total of 835 ICU nurses from at least 104 hospitals completed the questionnaires, and 777 were from hospitals in Guangdong Province. The mean score of 11 questions related to evidence-based guidelines for preventing CLABSIs was 4.02. Individual total scores were significantly associated with sex, length of time as an ICU nurse, educational level, professional title, establishment, hospital grade, and incidence of CLABSIs at the participant’s ICU. Importantly, only 43% of nurses reported always using maximum barrier precautions, 14% of nurses reported never using 2% chlorhexidine gluconate for antisepsis at the insertion site, only 40% reported prompt removal of the catheter when it was no longer necessary, and 33% reported frequently and routinely changing catheters even if there was no suspicion of a CLABSI.

Conclusion

Chinese ICU nurses in Guangdong Province lack of knowledge and practice of evidence-based guidelines for the prevention of CLABSIs. National health administrations should adopt policies to train ICU nurses to prevent CLABSIs.

Nursing students' knowledge on the management of peripheral venous catheters at Wollega University

BACKGROUND

Adherence to the best standards of nursing practice is the fundamental principle to improve patient outcome and prevent nursing procedure related-infections. A peripheral venous catheter (PVC) is the most common invasive procedure performed in nursing care. Its poor performance could expose patients to bloodstream-related infections. The present study aimed to assess post-basic nursing students' knowledge of evidence-based guidelines on the management of peripheral venous catheters.

METHODS

A cross-sectional study design was conducted on May 01-03, 2019, using a convenient sample 239 among post-basic nursing students in Wollega University.

RESULTS

The study result showed that nursing students' had a low mean (4.1±1.52) of knowledge about PVC procedure management. Only 41% of the respondents have adhered to recommendations of CDC guidelines. Among the provided options of the items, none achieved 100% correct answers. The majority of nursing students (77%) responded that antiseptic handwashing is always performed before insertion of PVCs. Meanwhile, few students (5%) correctly answered that the infusion set is recommended to be removed after 96 hours when neither lipids nor blood products are administered. In multivariable regression analysis, nursing students who had received training (AOR = 2.9, 95% CI (1.6, 5.1)) and who were younger (AOR = 2.4, 95% CI (1.3, 4.3)) significantly associated with a higher score of knowledge.

CONCLUSIONS

This study finding shows that an overall level of knowledge of post-basic nursing students is inadequate. Measurements such as an increase in the provision of adequate training by nurses educators based on evidence-based guidelines could improve the post-basic nursing students' knowledge.

Compliance of Middle Eastern hospitals with the central line associated bloodstream infection prevention guidelines

AIMS

The purposes of this study were to (1) assess compliance with the CLABSI prevention guidelines, (2) assess the predictors of compliance, and (3) investigate the effect of compliance on the rate of CLABSI and related mortality.

BACKGROUND

Implementation of the Central Line Associated Bloodstream Infection (CLABSI) prevention guidelines from the Centers for Disease Control and Prevention (CDC) helps to reduce the rate of CLABSI and related mortality, although the extent to which hospitals implement these guidelines is questionable.

METHODS

A prospective design was used in this study. Observations were conducted over three months in the intensive care units of 58 hospitals in three Middle Eastern countries. An observational checklist, based on the CDC guidelines, was used to assess compliance. The rate of CLABSI and related mortality were obtained from patients' records.

RESULTS

The degree of compliance, rate of CLABSI and mortality were highly variable. The multiple regression model showed that the hospitals' characteristics explained 82.0% of the variance of compliance (R2Adj= 0.820, F=29.82, p<0.05). The number of beds in the intensive care unit and patient-nurse ratio were significant predictors of compliance. A lower number of beds and a lower patient-to-nurse ratio were related to higher compliance. Moreover, higher compliance with CLABSI prevention guidelines was associated with lower rate of CLABSI and related mortality.

CONCLUSIONS

Improvement in the patients' outcome can be achieved through compliance with the CLABSI prevention guidelines. lowering patient-nurse ratio and the number of beds in the ICUs would help to improve compliance.

Knowledge and practices of isolation precautions among nurses in Jordan

Background

Implementation of isolation precautions from the Centers for Disease Control and Prevention (CDC) has been justified through research and clinical evidence. However, nurses' understanding and compliance with these precautions is still unknown. The aim of this study was to assess nurses' knowledge and practices in relation to isolation precautions in Jordan.

Methods

A cross-sectional, descriptive design was used. The study took place in 8 hospitals in Jordan. A self-reported questionnaire and an observational checklist were developed based on the CDC (2007) isolation precautions guidelines.

Results

A total of 247 questionnaires were returned out of 400, for a response rate of 61.7%. The results show that most nurses (90%) have good knowledge of isolation precautions. However, only 65% of nurses reported good compliance with isolation precautions. The results of a t test revealed that nurses with Bachelor's degrees perform better in knowledge examinations than nurses with 2-year diplomas (P < .001). However, there was no significant difference in knowledge and self-report practices scores based on nurses' previous training and existence of isolation guidelines in their units or wards (P > .05). The results of the checklists confirm that there is a low compliance with standard isolation practice. In addition, the checklist shows that a high percentage of units and wards do not use isolation signs (46.4%) and posters (34.5%).

Conclusions

This study revealed that educating nurses about isolation is not enough strategy to improve their compliance. It is important to adapt other strategies, such as supporting nurses by giving them a manageable workload, and providing more supplies and reminders of isolation precautions in the hospitals.

Educating intensive care unit nurses to use central venous catheter infection prevention guidelines: effectiveness of an educational course

Background

Nurses' knowledge of central venous catheter-related infection (CVC-RI) prevention guidelines is poor, indicating that nurses do not receive proper education about these guidelines.

Aim

The aim of this study was to evaluate the effectiveness of an educational course that aimed to improve nurses' knowledge about CVC-RI prevention guidelines.

Method

A sample of 131 nurses were randomly assigned to the experimental group (received an educational course) or control group (received no education). Pre-Post data were collected using a structured questionnaire that included a 23-item knowledge assessment.

Results

In the pre-test, all participants demonstrated poor knowledge, with mean scores of 8.2 (standard deviation = 3.6). After completion of the course, knowledge was significantly improved in the experimental group, whereas the control group showed no change (t(106,3) = 25.1, p = 0.00).

Conclusions

An educational course on CVC-RI prevention guidelines had an encouraging effect. Decision makers are recommended to implement such courses in their settings to improve nurses' competency.