Department of Health Sciences, Medical School, University of Catanzaro Magna Græcia, Catanzaro, Italy.
Am J Infect Control. 2013 Feb;41(2):107-12. doi: 10.1016/j.ajic.2012.02.038. Epub 2012 Sep 11.
We set out to acquire information about the knowledge, attitudes, and evidence-based practices associated with the insertion and maintenance of central vascular catheters (CVC) for the prevention of central line-associated bloodstream infections (CLABSI).
We selected all health care workers (HCW) in all units using CVCs in the Calabria region of Italy.
Correct answers about the knowledge of physicians and nurses ranged from 43% to 72.9% and were significantly higher in respondents who worked in intensive care unit (ICU) wards in hospitals that had a written policy about CVC maintenance and had active formal training. Respondents' attitudes toward general aspects of CLABSI prevention were very positive and were significantly higher for HCWs working in regional general hospitals, practicing in ICU wards, and having appropriate knowledge. Concerning HCWs, 83.9% reported that, if patients had any manifestations suggesting local or bloodstream infection, the dressing was removed for assessment purposes; this practice was significantly more likely to occur in HCWs having appropriate knowledge and positive attitudes and who worked in hospitals with a written policy about CVC maintenance.
The study demonstrated that written policies, formal training, and years of experience contributed to an increase in knowledge, practice, and positive attitudes toward CLABSI prevention. In addition the paper demonstrates how great this need is, having reported many non-evidence-based practices still continuing despite new evidence.
我们旨在获取有关预防中心静脉导管相关血流感染(CLABSI)的插入和维护的知识、态度和基于证据的实践的信息。
我们在意大利卡拉布里亚地区选择了所有使用中心血管导管(CVC)的单位的医护人员(HCW)。
医生和护士的正确答案在 43%至 72.9%之间,在那些在设有有关 CVC 维护的书面政策且有主动正式培训的医院的重症监护病房(ICU)工作的受访者中明显更高。受访者对 CLABSI 预防的一般方面的态度非常积极,在在地区综合医院工作、在 ICU 病房工作并且有适当知识的 HCW 中明显更高。关于 HCW,83.9%的人报告说,如果患者有任何提示局部或血流感染的迹象,会将敷料去除以进行评估;这种做法在具有适当知识和积极态度且在设有有关 CVC 维护的书面政策的医院工作的 HCW 中更有可能发生。
该研究表明,书面政策、正式培训和多年的经验有助于增加有关 CLABSI 预防的知识、实践和积极态度。此外,本文还表明了这种需求有多大,尽管有新的证据,但仍有许多非基于证据的实践在继续。