Csomós Akos, Orbán Ede, Konczné Réti Rózsa, Vass Erika, Darvas Katalin
Semmelweis Egyetem, Altalános Orvostudományi Kar I. Sebészeti Klinika Budapest Ulloi út 78. 1082.
Orv Hetil. 2008 May 18;149(20):929-34. doi: 10.1556/OH.2008.28346.
To determine intensive care unit (ICU) nurses' knowledge of evidence-based guidelines for preventing central venous catheter (CVC) related infection.
We used a validated multiple-choice questionnaire which was distributed to intensive care units between October and December 2006. We collected demographic data, like gender, years of ICU experience, number of ICU beds and whether respondents hold a special degree in intensive care.
We collected 178 questionnaires from 11 intensive care units; the mean score was 3.66 on 10 questions (37%). Eighteen per cent knew that CVCs should be replaced on indication only, and 61% knew that this recommendation concerns also replacement over a guidewire. Recommendations for replacing pressure transducers and tubing every 4 days, and for using coated devices in patients requiring a CVC < 5 days in settings with high infection rates were recognized only by 48% and 66%, respectively. Regarding CVC dressings, 15% knew that these should be changed only when indicated and at least once weekly, and 35% recognized that both poly-urethane and gauze dressings can be recommended. Only 20% checked 2% aqueous chlorhexidine as recommended disinfection solution; 14% knew antibiotic ointments are not recommended because they trigger resistance. The recommendation to replace administration sets within 24 hours after administering lipid emulsions was recognized by 85%, but it was known by 5% only that these sets should be replaced every 96 hours when administering neither lipid emulsions nor blood products. Professional seniority and the number of intensive care beds in the ICU where nurses work showed not to be associated with better scores on the test.
Knowledge regarding CVC-related infection is poor among Hungarian nurses. Prevention guidelines should be included in the nurse education curriculum as well as in continuing refresher nursing education programs.
确定重症监护病房（ICU）护士对预防中心静脉导管（CVC）相关感染的循证指南的了解程度。
我们使用了一份经过验证的多项选择题问卷，于2006年10月至12月分发给各重症监护病房。我们收集了人口统计学数据，如性别、ICU工作年限、ICU床位数量以及受访者是否拥有重症监护方面的专业学位。
我们从11个重症监护病房收集了178份问卷；在10个问题上的平均得分为3.66分（37%）。18%的人知道CVC仅应在有指征时更换，61%的人知道该建议也适用于通过导丝更换。每4天更换压力传感器和管路，以及在感染率高的环境中对需要CVC<5天的患者使用涂层装置的建议，分别只有48%和66%的人知晓。关于CVC敷料，15%的人知道仅在有指征时更换且至少每周更换一次，35%的人认识到聚氨酯和纱布敷料均可推荐。只有20%的人选择2%葡萄糖酸氯己定作为推荐的消毒溶液；14%的人知道不推荐使用抗生素软膏，因为它们会引发耐药性。85%的人知道在输注脂质乳剂后24小时内更换给药装置，但只有5%的人知道在既不输注脂质乳剂也不输注血液制品时，这些装置应每96小时更换一次。护士的专业资历以及其工作的ICU中的重症监护床位数量与测试中的较高分数无关。
匈牙利护士对CVC相关感染的了解较差。预防指南应纳入护士教育课程以及持续的护理进修教育项目中。
