الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Central venous catheter insertion is not a benign procedure. It is a potentially harmful one, if it is not performed correctly, it might result in life threatening complications. Thus, nurses should remain sensitive to possible hazards and complications and take all necessary precautions to ensure patients’ safety. With an increasing demand for intensive care beds more nurses in acute and high dependency wards will be expected to care competently for patients with central venous catheter.
All intensive care nurses should be aware when performing this intervention of the potential risk a patient is exposed to, and should make an effort to prevent or minimize these. Competent use of central Venous Catheter aids in the prevention of associated complications and therefore helps to improve patient outcomes. Therefore, the aim of the current study was to assess nurses’ performance toward CLABSIs and assess the factors affect their performance.
To achieve the aim of the current study, the following research questions were formulated:
1) What are the nurses’ levels of performance regarding central line associated bloodstream infection in critical care units?
2) What are the factors that affect nurses’ performance toward central line associated bloodstream infection in critical care units?
Research design:
A descriptive exploratory research design was utilized in the current study.
Methodology:
Setting
The study was conducted at intensive care units (ICUs) of Ain Shams University Hospitals.
Subject
A convenient Sample of 100 nurses was included in the study, representing all those who work in the selected intensive care units (ICUs) of Ain Shams University Hospitals. Nurses had a minimum of one year working experience, and were willing to participate in the current study with the following inclusion criteria: Both sexes and different nursing educational categories.
Tools of data collection
Four tools were utilized to collect data pertinent to the current study. They were developed by the investigator and reviewed by a panel of three experts in critical care nursing and medical specialties. The designed tools included the following:
1. Self administered questionnaire sheet:
It was used to assess nurses’ knowledge regarding central line associated bloodstream infection at critical care unit, it will be included two parts:
The first part: This sheet included data related to gender, age, educational level, area of work, years of experience in nursing and ICU and number of attended training courses about central line associated bloodstream infection.
The second part: It included 15 multiple choices questions related to nurses’ knowledge regarding Central Line Associated Bloodstream Infection.
2. Factors assessment questionnaire sheet:
It was used to assess the factors that affecting nursing performance toward central line associated bloodstream infection at critical care unit.
3. Nurses practices observational checklists:
This tool was developed by the researcher to assess nurses’ practice regarding central line associated bloodstream infection.
4. Nurses attitude Likert scale:
This tool was developed by the researcher to assess nurses’ attitude toward Central Venous Catheter CVC and CLABSI in critical care unites.
Result:
Statistical findings of the current study revealed the following:
- Concerning personal background data of the studied sample;
Around half (55%) of the studied sample are Males, had bachelor nursing degree (49%) and (72%) in the age group of 16 -25.
About two third of the studied sample had (1 – 5) years of experience in their work place as nurses (58%) and (48%) of the studied sample had less than one year experience in the ICU.
- As regards to knowledge assessment, the current study revealed that around (92%) of the studied sample had unsatisfactory knowledge level (<90%).
- As regards to nurses’ practice, the current study revealed that the great majority (91%) of the studied sample had unsatisfactory practice level (less than 90%).
- As regards to nurses’ attitude, the current study revealed that the majority (57%) of the studied nurses had negative attitude toward CLABSI
- As regards to factors assessment, the current study revealed that the factors were suggested by researcher affect the nurses’ performance toward Central Line Associated Bloodstream Infections in percentage(88%) and these factors are:
1. The presence a clear instructions in setting help the nurses to use central venous catheter correctly.
2. The availability of all required equipment for caring of central venous catheter in the setting affects the nurses’ performance.
3. Presence of infection control strategies at the work setting affect incidence of central line associated bloodstream infection.
4. Presence of infection controls’ team training improves the nurses’ performance toward central line associated bloodstream infection.
5. The presence of surveillance for central line associated bloodstream infection affect the incidence of infection.
6. Assessing site of central venous line insertion daily help to decrease incidence of central line associate bloodstream infection.
7. Increasing body temperature of the patient with central venous line may be sign of central line associated bloodstream infection.
8. Excluding presence of central line associated bloodstream infection, is important to make sure that there is no another site infection.
9. Assessing vital signs before central line insertion is important to prevent CLABSIs.
10. Bad general patient hygiene after inserting central line increase risk of central line associate bloodstream infection.
11. The presence of shortage in nursing staff number increase risk of central line associated blood stream infection.
12. The nurses’ job satisfaction levels affecting the incidence of central line associate bloodstream infection.
13. The periodically assessment of nurses knowledge toward central line associate bloodstream infection improves their performance.
14. Assessment the patient’s signs of infection are the responsibility of nurses to detect presence of CLABSIs.
15. The levels of education of staff nurses affect central line associated bloodstream infection.
- As regard to relations between the study’ variables:
– There is statistically significance in the mean knowledge scores in relation to years of experience in the intensive care unit (p =0.009). And there is no statistically significance between total knowledge scores in relation to gender, age, qualification and years of experiences in the field of nursing.
A statistically significance in the total practice scores in relation to years of experience in the intensive care unit (p =0.048) respectively. And there is no statistically significance between total practice scores in relation to gender, age, qualification and years of experiences in the field of nursing.
There is no statistically significance in the total Attitude scores in relation to years of experience in the intensive care unit, gender, age, qualification and years of experiences in the field of nursing.
There is high significant statistical positive correlation between total knowledge and total practice (P< 0.001), also there is high significant statistical positive correlation between total knowledge and total attitude (P< 0.001), the same between total practice and total attitude (P< 0.001).
There is significant statistical positive correlation between total knowledge and the factors that related to work setting (P= 0.034)and the factors related to patient (P= 0.033), so there is positive correlation between total knowledge and the factors affect the nurses’ performance (P= 0.028), there is significant statistical positive correlation between total practice and the factors that related to patient (P= 0.045), so there is positive correlation between total practice and the factors affect the nurses’ performance (P= 0.022), also there is significant statistical positive correlation between total attitude and the factors that related to patient (P= 0.050), so there is positive correlation between total attitude and the factors affect the nurses’ performance (P= 0.044).