Division of Emergencies and Critical Care, Oslo University Hospital, Norway.
Lovisenberg Diaconal University College, Norway.
Intensive Crit Care Nurs. 2022 Apr;69:103182. doi: 10.1016/j.iccn.2021.103182. Epub 2022 Jan 4.
To explore intensive care nurses' experiences with and perceptions of using a standardised central venous catheter procedure to prevent bacterial contamination when accessing patients' central venous catheters.
This study employed an interpretative qualitative design. Data was collected through semi-structured, individual interviews and Qualitative Content Analysis was used in data analysis.
Seven Norwegian intensive care nurses were recruited using a purposeful sampling strategy.
Three main themes were identified. 1). Individualised practice revealed varying knowledge of and commitment to following the central line procedure. 2). Risk desensitisation revealed a continuous use of central lines, acute situations and a lack of information on infections, which affect usage. 3). Professional working culture showed nurse-to-nurse interaction, which promoted compliance with the procedure. Their interplay created a team spirit whereby nurses worked together to improve patient safety.
This study shows the diversity and complexity of factors affecting intensive care nurses' procedure compliance when accessing central lines. The themes of Individualised practice and Risk desensitisation pose a substantial threat to healthcare quality and patient safety in the ICU. Exposure to infection risks could be reduced by applying these themes to inform and strengthen continuing education programs and audit processes. The theme of Professional working culture shows the positive influence nurses can have on each other, promoting compliance when accessing central lines. Intensive care nurses should be aware that their voice matters and that challenging poor practice does not have to be confrontational. Leadership should look for ways to encourage this type of nurse-to-nurse interaction.
探讨重症监护护士在使用标准化中心静脉导管置管程序预防患者中心静脉导管细菌污染方面的经验和看法。
本研究采用解释性定性设计。通过半结构化个体访谈收集数据，并使用定性内容分析法进行数据分析。
挪威 7 名重症监护护士采用目的抽样策略招募。
确定了三个主要主题。1）个体化实践揭示了对中心线路程序的知识和遵守情况存在差异。2）风险脱敏揭示了持续使用中心线路、急性情况以及缺乏关于感染的信息，这些因素影响了使用。3）专业工作文化显示了护士之间的互动，促进了对该程序的遵守。他们的相互作用营造了一种团队精神，护士们共同努力提高患者的安全性。
本研究表明，在接触中心线路时，影响重症监护护士程序遵守的因素具有多样性和复杂性。个体化实践和风险脱敏这两个主题对 ICU 中的医疗质量和患者安全构成了重大威胁。通过应用这些主题来为继续教育计划和审核流程提供信息并加强这些主题，可以降低感染风险。专业工作文化的主题显示了护士之间的积极影响，有助于在接触中心线路时提高遵守程度。重症监护护士应该意识到他们的意见很重要，并且不必对抗性地挑战不良做法。领导层应寻找鼓励这种护士之间互动的方法。
