School of Nursing, Guangdong Medical University, No. 1 Xincheng Road, Songshan Lake Science and Technology Industrial Park, Dongguan, 523808, Guangdong, China.
School of Nursing, Heze Medical College, Heze, 274000, Shandong, China.
Antimicrob Resist Infect Control. 2020 Nov 16;9(1):186. doi: 10.1186/s13756-020-00833-3.
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.
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).
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.
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.
当遵循基于证据的指南时，中心静脉相关血流感染（CLABSI）在很大程度上是可以预防的。然而，目前尚不清楚这些指南在中国的重症监护病房（ICU）中执行情况如何。本研究旨在评估中国 ICU 护士对美国疾病控制与预防中心和英国卫生部发布的预防 CLABSI 的循证指南的知识和实践情况。
2019 年 6 月至 7 月，护士通过在线问卷的形式，完成有关预防 CLABSI 的循证指南的知识和实践情况的调查。问卷由 11 个问题组成，正确回答 1 个问题得 1 分（总分=0-11 分）。
共 835 名来自至少 104 家医院的 ICU 护士完成了问卷，其中 777 名来自广东省的医院。11 个与预防 CLABSI 的循证指南相关的问题的平均得分为 4.02。个人总分与性别、在 ICU 担任护士的时间长短、教育程度、职称、机构类型、医院等级以及 ICU 中 CLABSI 的发生率显著相关。重要的是，只有 43%的护士报告总是使用最大屏障预防措施，14%的护士报告从不使用 2%葡萄糖酸洗必泰进行插管部位的消毒，只有 40%的护士报告在不再需要时及时拔除导管，33%的护士报告即使没有怀疑 CLABSI 也经常和常规更换导管。
广东省的 ICU 护士对预防 CLABSI 的循证指南知识和实践不足。国家卫生行政部门应采取政策，培训 ICU 护士预防 CLABSI。
