Knowledge, Attitudes and Practice on the prevention of Central Line Associated Bloodstream Infection among nurses in CWMH, Suva: A Cross-Sectional Study.

Researchers: Namedre A1
Primary supervisor: Bennett E2
Researcher Affiliations:
1Department of Anesthesia & Intensive Care, CWM Hospital, Suva, Fiji Islands.
2Department Anesthesia, College of Medicine, Nursing and Health Sciences, Fiji National University, Suva, Fiji Islands.
Key Words: Central Line associated bloodstream infection, central venous catheter, care bundles, nurses, knowledge, attitudes, perceptions, staff nurses, CWM Hospital
Introduction: Central line associated bloodstream infection (CLABSI) is a common hospital acquired infection with a reported mortality of about 18%. The use of the CLABSI bundles which involves strict hand hygiene, standardized dressing change protocols, aseptic techniques during CVC line access/dressing change, daily evaluation of line and prompt removal of line have been advocated to decrease the CLABSI rate to <1 per 1000 central line days which is the aim for all ICUs that uses it as a quality indicator. Adequate knowledge on prevention of CLABSI among nurses can also halt the incidence to a significant level. The objective of the cross sectional study was to delineate the knowledge, attitudes and behavior among nurses regarding the prevention of CLABSIs and to identify their predisposing factors.
Method: This study was a quantitative, descriptive, cross sectional study that was carried out with registered nurses working in the Intensive care Unit, Medical and Surgical wards at the Colonial War Memorial Hospital, Suva. A questionnaire was self-administered from May to August 2019 which gathered information on demographic; knowledge about evidence-based practices for the prevention of CLABSI; attitudes towards guidelines, the risk of transmitting infections and hand-washing when using central venous catheters (CVC); practice about catheter site care; and sources of information.
Results: This study showed that nurses have an adequate level of knowledge concerning evidence based references for preventing CLABSI, since majority knew that they had to flush the lumen with N/Saline after administration of medication/fluid, type of dressing and that the needleless connectors needed to be disinfected before giving medication and fluid. In contrast, there were areas where the knowledge was lower, mainly regarding the agent for skin disinfectant with hydrogen peroxide, use of topical antibiotic on catheter insertion and catheter site dressing. Also adherence to hand hygiene was alarming low which was concerning as hands represent the main route of transmission of hospital pathogens.
Conclusion: Some limitation of the study was that 29 nurses were not part of the study and may skew results. Also due to time restraints and rapid movement of the nurses a post test was not administered. However, it is evident that educational interventions should be implemented to address the gaps of knowledge regarding knowledge and practice on the prevention of CLABSIs and to ensure that nurses use evidence-based prevention intervention.