Prevention of central line-associated bloodstream infections: ICU nurses' knowledge and barriers

Nurs Crit Care. 2023 May;28(3):419-426. doi: 10.1111/nicc.12757. Epub 2022 Feb 3.

Abstract

Background: Central line-associated bloodstream infections (CLABSI) have been a significant challenge in care, increasing healthcare costs and leading to adverse outcomes, including mortality.

Aim: The present study aimed to assess the knowledge of intensive care unit (ICU) nurses on the prevention of CLABSI and the implementation barriers of evidence-based guidelines in practice.

Design: A cross-sectional study.

Methods: Data were collected from adult, paediatric, and neonatal ICU nurses working in seven hospitals in Iran, using census sampling from April to July 2020.

Results: A number 209 out of 220 ICU nurses participated in the present study (response rate of 95%). The median score of knowledge of ICU nurses towards the prevention of CLABSI was 3.00 out of 11. 50.72% of ICU nurses had insufficient knowledge. The most critical implementation barriers of evidence-based guidelines were high workload, shortage of necessary equipment, and lack of CLABSI prevention workshops.

Conclusions: Overall, the knowledge of ICU nurses towards the prevention of CLABSI was insufficient. Study findings suggest that the knowledge of ICU nurses may be improved by reducing the workload, increasing the number of nursing staff in the ICU, having an adequate supply of equipment needed to ensure safe practice in the ICU, and providing regular related educational workshops for nurses working in the ICU.

Relevance to clinical practice: The present study's findings suggest that regular training programs should be developed to improve the knowledge of ICU nurses in the care and prevention of CLABSI. Nursing policymakers and managers need to identify and address implementation barriers of evidence-based guidelines to improve nursing, such as high workload, shortage of necessary equipment, and lack of CLABSI prevention workshops.

Keywords: barriers; central venous catheter; critical care; knowledge; nurses.

MeSH terms

  • Adult
  • Catheter-Related Infections* / prevention & control
  • Catheterization, Central Venous* / adverse effects
  • Child
  • Clinical Competence
  • Cross-Sectional Studies
  • Humans
  • Infant, Newborn
  • Intensive Care Units
  • Intensive Care Units, Neonatal
  • Nurses*
  • Sepsis* / prevention & control