الفهرس 
Abstract
Central Venous CatheterOnly 14 pages are availabe for public view
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Abstract
Summary
A Central Venous Catheter (CVC) is an essential element of modern healthcare all over the world. Many of the evidence-based procedures used to insert CVCs are also essential for the care and maintenance of these catheters (e.g., hand hygiene, proper skin antisepsis at the insertion site, site dressing, thorough disinfection of CVC hubs and injection ports, changing of administration sets and fluids, regular evaluation of the continuing need for CVC)
Care bundles are a package of three to five evidence based measures that are reliably and effectively implemented together to improve care quality. Care bundles are widely used in healthcare settings in order to prevent and manage various health conditions. Nurses play a crucial role in preventing central venous catheter complications. Central line insertion poses a significant risk, but proper nursing and maintenance are vital to preventing complications
The findings of the current study provided a base of knowledge for ICU nurses on central venous catheter management, and ensure the highest standards of nursing management that is aiming at improving patients’ outcomes. They should be well educated to use strategies to decrease central venous catheter infection rates to improve patient’s outcomes.
Aim of the study:
To evaluate the effect of an educational program on critical care nurses’ knowledge, practice, and patient’s outcomes about central venous catheter bundle.
Research design:
Quasi-experimental research design was used to successfully complete this study with studied.
Setting:
The study was executed at the General Intensive Care Unit, in Main Assiut University Hospital.
Sample:
Critical Care Nurses:
A convenient sample of 60 CCNs working in General Intensive Care Unit, Assiut University Hospital.
Critical Ill Patients:
A convenient sample of 60 critically ill patients had been chosen then assigned randomly into two groups (study and control groups). The study group (30 patients) who received nursing educational program, while the control group (30 patients) who received routine care.
Tools:
Three tools were used in this study as follows.
Tool One:” Knowledge Assessment Tool”: -
This tool was developed by the researcher after reviewing the related literatures to assess the knowledge level of CCNs regarding the central venous catheter bundle. This tool was used once before the start of educational program. This tool comprised of two parts:
Part I: ”Socio Demographic Data”, which included: nurse’s age, sex, CCNs educational level, experience years, previous training about CVC care and source of their information and knowledge.
Part II: ”Nurses’ Knowledge Assessment”, which assessed nurses’ knowledge about definition of central venous catheter, indication and contraindication of central venous catheter, types of central venous catheter, definition of the Central Line- Associated Bloodstream Infections (CLABSI), risk factors, and bundle of care of central venous catheter.
Scoring system:
The complete correct answer was given a score of 2 and incomplete answer was given a score of 1. While, an incorrect or don’t know answer was obtained a score of zero. The total score was summed up and nurses who obtained less than 60 % of total score was considered as having satisfactory knowledge. However, those who obtained less than 60 % of total score were considered as having unsatisfactory knowledge.
Tool Two: ”Practice Assessment Tool”:
(observational checklist sheet) this tool was developed by the researcher after reviewing related literatures to assess CCNs practice level about how they implement and comply with the central venous catheter insertion and maintenance care bundle.
Tool Three: ”Patients’ Outcomes Tool”:
This tool was developed by the researcher after reviewing related literatures to evaluate the patient’s outcomes. It included the following parts:
I: ”Socio Demographic Data’’, which included: patients’ age, sex, date of admission, date of discharge, initial diagnosis, past medical and surgical history.
II: ”Central Venous Catheter Assessment Data” which included: date of CVC insertion, date of CVC removal, duration, insertion site, number of dressing per day, and number of CVC inserted to the same patients.
III: ”Central Venous Catheter Complications”:- Central line associated blood stream infection
IV: ”Days of ICU staying”.
Results:
There was highly significant increase in the percentage of satisfactory knowledge of critically care nurses after educational program compared with that before educational program (0.0% Vs. 86.7%) before and after intervention, respectively with minimal decline of satisfactory knowledge at follow up to 75 % (P value was 0.00001).
There was highly significant increase in the percentage of satisfactory practice of critically care nurses after educational program compared with that before educational program (15% Vs. 100%) before and after intervention, respectively with minimal decline of satisfactory practice at follow up to 81.7 % (P value was 0.0001).