Muschitiello Vito, Marseglia Carmela, Cusanno Luisa, Termine Monica, Morgigno Aurora, Schingaro Martina, Calamita Maurizio
Department of Emergency and Urgency, Azienda Ospedaliera Universitaria Consorziale Policlinico of Bari, Bari, Italy.
Azienda Ospedaliera Universitaria Consorziale Policlinico of Bari, Bari, Italy.
J Vasc Access. 2025 Jul;26(4):1161-1172. doi: 10.1177/11297298241262975. Epub 2024 Jul 27.
Management of central venous catheters (CVC) is a frequent procedure in intensive care units (ICUs) and the risk of bloodstream infections (CLABSI) is found to be high. The literature provides healthcare professionals with guidelines to prevent the risk of CLABSI infections. The aim of this study was to observe the knowledge, attitudes, and practices of ICU nurses on the prevention of CLABSI.
A multicenter cross-sectional study was conducted between March 2023 and September 2023; the research was carried out among six ICUs in Bari both on the web and in paper mode. The survey consisted of multiple-choice questions structured in two sections: demographic sample data and the 2017 Esposito MR questionnaire, drawn up based on the 2011 guidelines of the Centers for Disease Control and Prevention, consisting of four dimensions: knowledge, attitudes, practices, information.
121 nurses (57.1%) participated in the study. 72% were unfamiliar with the guidelines, especially nurses aged 41-50 years (RR = 1.88; CI = 0.78-4.51; = 0.13) and more than 10 years' work experience (RR = 1.56; CI = 0.76-3.23; = 0.20). Regarding attitudes, nurses were aware of the usefulness of the guidelines (Me = 10; IQR = 8-10) and the importance of hand washing for prevention (Me = 10; IQR = 10-10) despite 39.7% ( = 48) believing that gloves replace hand washing, and there were no statistically significant differences in comparing scores with age, work experience, and educational qualification. 96.7% always substituted dressing for CVC; 120 nurses (99.2%) were always replacing infusion sets and 71.2% always sanitized the access ports before infusions. Finally, 102 participants (84.3%) felt the need to get more information about the prevention of CLABSI.
We observed a reduced knowledge of the guidelines for the prevention of CLABSI despite the attitudes and practices of the nurses being satisfactory. In addition to implementing training, strategies for disseminating guidelines should be adopted.
中心静脉导管（CVC）管理是重症监护病房（ICU）的常见操作，发现血流感染（CLABSI）风险很高。文献为医护人员提供了预防CLABSI感染风险的指南。本研究的目的是观察ICU护士在预防CLABSI方面的知识、态度和实践。
2023年3月至2023年9月进行了一项多中心横断面研究；该研究在巴里的六个ICU以网络和纸质方式进行。调查由两部分构成的多项选择题组成：人口统计学样本数据和2017年埃斯波西托MR问卷，该问卷根据疾病控制与预防中心2011年的指南编制，包括四个维度：知识、态度、实践、信息。
121名护士（57.1%）参与了研究。72%的人不熟悉这些指南，尤其是41至50岁的护士（相对风险RR = 1.88；置信区间CI = 0.78 - 4.51；P = 0.13）以及工作经验超过10年的护士（RR = 1.56；CI = 0.76 - 3.23；P = 0.20）。关于态度，护士们意识到指南的有用性（中位数Me = 10；四分位间距IQR = 8 - 10）以及洗手预防的重要性（Me = 10；IQR = 10 - 10），尽管39.7%（n = 48）的人认为手套可以替代洗手，并且在按年龄、工作经验和学历比较得分时没有统计学上的显著差异。96.7%的人总是更换CVC的敷料；120名护士（99.2%）总是更换输液器，71.2%的人在输液前总是对接入口进行消毒。最后，102名参与者（84.3%）觉得有必要获取更多关于预防CLABSI的信息。
尽管护士的态度和实践令人满意，但我们观察到他们对预防CLABSI指南的了解有所减少。除了开展培训外，还应采用传播指南的策略。
