Knowledge, attitudes, and practice on the prevention of central line-associated bloodstream infections among nurses in oncological care: A cross-sectional study in an area of southern Italy

Abstract

The objectives of the cross-sectional study were to delineate the knowledge, attitudes, and behavior among nurses regarding the prevention of central line-associated bloodstream infections (CLABSIs) and to identify their predisposing factors. A questionnaire was self-administered from September to November 2011 to nurses in oncology and outpatient chemotherapy units in 16 teaching and non-teaching public and private hospitals in the Campania region (Italy). The questionnaire gathered information on demographic and occupational characteristics; knowledge about evidence-based practices for the prevention of CLABSIs; attitudes towards guidelines, the risk of transmitting infections, and hand-washing when using central venous catheter (CVC); practices about catheter site care; and sources of information. The vast majority of the 335 nurses answered questions correctly about the main recommendations to prevent CLABSIs (use sterile gauze or sterile transparent semipermeable dressing to cover the catheter site, disinfect the needleless connectors before administer medication or fluid, disinfect with hydrogen peroxide the catheter insertion site, and use routinely anticoagulants solutions). Nurses aged 36 to 50 years were less likely to know these main recommendations to prevent CLABSIs, whereas this knowledge was higher in those who have received information about the prevention of these infections from courses. Nurses with lower education and those who do not know two of the main recommendations on the site’s care to prevent the CLABSIs, were more likely to perceive the risk of transmitting an infection. Higher education, attitude toward the utility allow to dry antiseptic, and the need of washing hands before wearing gloves for access to port infusion were predictors of performing skin antiseptic and aseptic technique for dressing the catheter insertion site. Educational interventions should be implemented to address the gaps regarding knowledge and practice regarding the prevention of CLABSIs and to ensure that nurses use evidence-based prevention interventions.

The adherence to guidelines for preventing CVC-related infections: a survey among Italian health-care workers

“…In the all sample, 28.6% of the interviewed reported to insert CVCs: a scarce level in the application of evidence-based recommendations, as listed in Table 3 , was shown in this subgroup, in concordance with the results reported by Alkubati et al, [ 22 ] but displayed a lower level of proper practices if compared with a recently published research conducted in Campania area just few months after the publication of CDC guidelines. [ 11 ]…”

“…[ 7 – 10 ] In Italy, to the best of our knowledge, there has been little information available addressing HCWs’ knowledge, attitudes, and practices regarding CVCs use. [ 11 , 12 ]…”

Current practice in dialysis central venous catheter management: Multi‐disciplinary renal team perspectives

“…Thus, nurses clearly play a pivotal role in dialysis CVC care. In other clinical settings, knowledge and skills of qualified nurses' about dialysis CVC care is often reported to be inadequate and insufficient . However, little research exists that has evaluated the nurses' roles in relation to dialysis CVC outcomes.…”

“…In other clinical settings, knowledge and skills of qualified nurses' about dialysis CVC care is often reported to be inadequate and insufficient. [15][16][17] However, little research exists that has evaluated the nurses' roles in relation to dialysis CVC outcomes. Clearly, there is an urgent need for a detailed exploration of nurses' contributions to dialysis CVC outcomes.…”

Improving Hand Hygiene Practices to Reduce CLABSI Rates: Nurses Education Integral for Success

“…This study clearly highlights the importance of implementing educational interventions to address the gaps in knowledge and practice to improve the compliance with the use of evidence-based prevention interventions for CLABSI among nurses. 19…”