Year 2021,
Volume: 34 Issue: 3, 298 - 306, 27.10.2021
Gulnur Kar
Ebru Erek Kazan
References
- [1] Kurt B. Evidence-based nursing practices to prevent central
venous catheter infections. Journal of Adnan Menderes
University Health Sciences Faculty 2018;2:21-7.
- [2] Hakyemez IN, Yildirmak MT, Cetmeli G, Iris NE. Prevalence,
causative microorganisms, and risk factors of central venous
catheter-related infections in a tertiary care hospital. Abant
Med J 2016;5:108-17.
- [3] Wright MO, Decker SG, Allen-Bridson K, Hebden JN,
Leaptrot D. Healthcare–associated infections studies project:
An American Journal of Infection Control and National
Healtcare Safety Network data quality collaboration: Location
mapping. Am J Infect Control 2018;46:577-8. https://doi.
org/10.1016/j.ajic.2017.12.012.
- [4] Karasu D, Yilmaz C, Durmus G, Ozer D, Caglayan U,
Karaduman I, Asan A. Evaluation of healthcare-associated
infections in critically ill patients receiving long-term
treatment in the intensive care unit. Klimik Journal 2016;
29:71-6. doi:10.5152/kd.2016.17
- [5] Zabidi HAZ, Ali GM, Naqshbandi E. The effect of nurses’
implementation of central vascular catheter maintenance
care bundle on bloodstream infection among ICU patients
in KFGH and KAAUH. International Journal of Nursing
Didactics 2018; 7:10-6. doi: 10.15520/ijnd.v7i12.2153
- [6] Sanli D, Sarikaya A. Evidenced-based nursing care
management at central venous catheters. Journal of the
Turkish Society of Critical Care Nurses 2016;20:84-97.
- [7] Alkubati SA, Ahmed NT, Mohamed ONE, Fayed AM, Asfour
HI. Health care workers’ knowledge and practices regarding
the prevention of central venous catheter-related infection. Am
J Infect Control 2015;43:26-30. doi:10.1016/j.ajic.2014.09.021
- [8] Bati B, Ozyurek P. Knowledge levels of intensive care unit
nurses on central venous catheters. Journal of Medical
and Surgical Intensive Care 2015;6:34-8. doi: 10.5152/
dcbybd.2015.828
- [9] Gnanarani J, Venkatesan L, Manikandan. Effectiveness
of central line bundle care upon the knowledge and
compliance staff nurses in the ICU. International Journal of
Advance Research, Ideas and Innovations in Technology
2018;4:2059-63. https://www.ijariit.com/manuscripts/v4i3/
V4I3-1793.pdf Accessed: June 25, 2019
- [10] Manzo BF, Mariano DR, Ferreira FMC, et al. Knowledge
and behavior of professionals about bundled strategies of
central venous catheter. Rev Bras Enferm 2019;72:50-6. doi:
10.1590/0034-7167-2018-0164.
- [11] Mutlu EY, Senturan L. Effects of hickman catheter care
training on practices of nurses. International Journal of Caring
Sciences 2017; 10 :16-33.
- [12] Ozen N, Kose T, Terzioglu F. Evidence-based practices in the
prevention of central venous catheter infections: Knowledge
of intensive care nurses. Turk J Intensive Care 2020;18:91-8.
doi: 10.4274/tybd.galenos.2019.25991
- [13] Sharour A. Oncology nurses’ knowledge about central line
catheter: caring, complications, and applications among cancer
patients – a cross-sectional study. J Vasc Nurs 2018;36:145-8.
doi:10.1016/j.jvn.2018.04.002.
- [14] Gillespie BM, Polit DF, Hamlin L, Chaboyer W. Developing a
model of competence in the OR: Psychometric validation of
perceived perioperative competence scale-revised. Int J Nurs
Stud 2012;49:90-101. doi:10.1016/j.ijnurstu.2011.08.001.
- [15] Infection prevention and control of healthcare-associated
infections in primary and community care. National Institute
for Health and Care Excellence 2012. https://www.nice.org.uk/
guidance/cg139/resources/healthcareassociated-infectionsprevention-
and-control-in-primary-and-community-carepdf-
351.095.18767045 Accessed:July 11, 2019
- [16] Arslan GG, Ozden D, Alan N, Yilmaz I, Ayik C, Goktuna G.
Examination of nursing drug administration practices via
central venous catheter: An observational study. J Vasc Access
2020;21:426-33. doi: 10.1177/112.972.9819880979.
- [17] Devi R, Ghai S, Singh NV, Puri GD. A methodological study to
develop a standard operational protocol for nurses on central
line catheter care of patients in selected intensive care units.
Indian J Crit Care Med 2017;21:483-7. doi: 10.4103/ijccm.
IJCCM_261_16.
- [18] Gerceker G, Yardimci F, Aydinok Y. Randomized controlled
trial of care bundles with chlorhexidine dressing and advanced
dressing to prevent catheter related bloodstream infections in
pediatric hematology-oncology patients. Eur J Oncol Nurs
2017;28:14-20. doi:10.1016/j.ejon.2017.02.008.
- [19] Marschall J, Mermel LA, Fakih M, et al. Strategies to prevent
central line-associated bloodstream infections in acute care
hospitals. Infect Control Hosp Epidemiol 2014;35:753-71.
doi:10.1086/676533.
- [20] Global Infection Prevention and Control Unit. Evidence of
hand hygiene as the building block for infection prevention
and control. World Health Organization 2017. https://
creativecommons.org/licenses/by-nc-sa/ 3.0/igo. Accessed:
August 4, 2019
- [21] Caner N, Tekinsoy KP. The assessment of the intramuscular
and intravenous drug administration steps of nurses:
Observation study. HUHEMFAD-JOHUFON 2019;6:177-85.
doi: 10.31125/hunhemsire.630812.
- [22] Kazan EE, Gorgulu S. Skills of the nurses about the
administration of subcutaneous low molecular weight heparin
injection. HUHEMFAD-JOHUFON 2009:1-13.
- [23] Acun A, Caliskan N. Evaluation of effectiveness of central
venous catheter related bloodstream infections in the antesty
and reanimation intensive care units of the bundle. Ann Med
Res 2021;28:792-8. doi: 10.5455/annalsmedres.2020.06.587.
- [24] Berman A, Snyder SJ. Kozier& Erb’s fundamentals of nursing,
concepts, process and practice. 10th ed. Pearson, 2015: 814-27.
- [25] Iseri A, Cinar B, Duzkaya DS, , et al. National vessel access
management guide. Turkish Journal of Hospital Infections
2019;23:1-54. http://www.hider.org.tr/global/Dernek_
Kilavuzlari/HID_Damar%20Erisimi%20Rehberi_2019.pdf .
Accessed: August 16, 2019
- [26] Lynn P B. Taylor’s clinical nursing skills. A nursing process
approach. 5th ed. Philadelphia, PA:Wolters Kluwer, 2018: 813-
21.
- [27] O’Grady NP, Alexander M, Burns LA, et al. Guidelines for the
prevention of intravascular catheter-related infections. Clin
Infect Dis 2011;52:162-93. doi:10.1093/cid/cir257.
- [28] Sardan YC, Guner R, Cakar N, et al. Guidelines for the
prevention of intravenous catheter infections. Turkish
Journal of Hospital Infections 2013;17:233-78.http://www.
hider.org.tr/global/Dernek_Kilavuzlari/Damar_ici_Kateter_
infeksiyonlarinin_Onlenmesi_Kilavuzu.pdf. Accessed: July
25, 2019
- [29] Esposito MR, Guillari A, Angelillo IT. Knowledge, attitudes,
and practice on the prevention of central line-associated
bloodstream infections among nurses in oncological care: A
cross-sectional study in an area of Southern Italy. PloS One
2017;12:1-11. doi:10.1371/journal.pone. 0180473.
- [30] Aydogdu S, Akgun M. Determination of knowledge levels
of nurses and the factors affecting the level of knowledge
in central venous catheter care. Clinical Nursing Studies
2020;8:1-9. https://doi.org/10.5430/cns.v8n2p1.
- [31] Preventing central line–associated bloodstream infections:
A global challenge, a global perspective. The Joint
Commission 2012. https://www.jointcommission.org/-/
media/deprecated-unorganized/imported-assets/tjc/
system-folders/topics-library/clabsi_monographpdf.
pdf?db=web&hash=86103821F3C7FF8A7683C933EA0CB391
Accessed: March 7, 2019
- [32] Abdo NM, Fadhli MA. Improving hand hygiene compliance
among healthcare workers in intensive care unit: an
interventional study. Int J Community Med Public Health
2018;5:3747-52.http://dx.doi.org/10.18203/2394-6040.
ijcmph20183558.
- [33] Yurttas A, Kaya A, Engin R. Examination of hospital
infection and hand hygiene compliance in intensive care
unit of a university hospital. Arch Health Sci Res 2017;4 :1-7.
doi:10.17681/hsp.115490.
- [34] Snarski E, Mank A, Iacobelli S, et al. Current practices used for
the prevention of central venous catheter-associated infection
in hematopoietic stem cell transplantation recipients: A
survey from the infectious diseases working party and nurses’
group of EBMT. Transpl Infect Dis 2015;17:558-65. https://
doi.org/10.1111/tid.12399.
- [35] Lai NM, Lai AN, O’Riordan E, et al. Skin antisepsis for reducing
central venous catheter-related infections. Cochrane Database
of Syst Rev 2016;7: CD010140. doi: 10.1002/14651858.
CD010140.pub2.
- [36] Central venous catheter hub cleaning prior to accessing.
Centers for Disease Control and Prevention 2011. https://
www.cdc.gov/dialysis/PDFs/collaborative/Protocol-Hub-
Cleaning-FINAL-3-12.pdf. Accessed: August 20, 2019
- [37] Preventing central line–associated bloodstream infections:
Useful tools, an international perspective, scrub the hub. The
Joint Commission 2013. https://www.jointcommission.org/-/
media/tjc/documents/resources/health-services-research/
clabsi-toolkit/clabsi_toolkit_tool_3-21_scrub_the_hubpdf.
pdf?db=web&hash=79BF0D29BD4AAF13DEC3C3DE5AB90494.
Accessed: August 20, 2019
- [38] Wright MO, Tropp J, Schora DM, Grant MD, Peterson K.
Continuous passive disinfection of catheter hubs prevents
contamination and bloodstream infection. Am J Infect
Control 2013;41:33-8. doi:10.1016/j.ajic.2012.05.030.
- [39] Desra AP, Breen J, Harper S, Slavin MA, Worth LJ. Aseptic
technique for accessing central venous catheters: Applying
a standardized tool to audit ‘scrub the hub’ practices. J Vasc
Access 2016;17:269-72. doi:10.5301/jva.5000509.
- [40] Hosaf S. Investigation of the effectiveness of continuous
education given with internet-mediated communication to
nurses on central venous catheter care management (thesis).
Izmir: Ege Univ; 2019.
Evaluation of skills of intensive care nurses regarding central venous catheter care: An observational study
Year 2021,
Volume: 34 Issue: 3, 298 - 306, 27.10.2021
Gulnur Kar
Ebru Erek Kazan
Abstract
Objective: Central venous access is a common procedure performed in many clinical settings for a variety of indications. Yet, there
are multiple complications related to central venous catheter use. Significant morbidity and mortality can result from complications
related to central venous catheters. Therefore, safety and effectiveness of central venous catheter care by nurses is crucial. The aim of
this study was to evaluate the intensive care nursing skills associated with central venous catheter care.
Materials and Methods: This observational study was conducted with 37 volunteer nurses who were employed in adult intensive care
units of three hospitals in Istanbul, Turkey. A total of 111 observations were collected by using the Nurses’ Descriptive Characteristics
Form and the Intensive Care Nurses’ Central Venous Catheter Care Skills Observation Checklist.
Results: The average age of the nurses was 33.2 ± 5.9 years. The study showed that 93.7% nurses had performed the hand hygiene
before starting the central venous catheter care but seldom after the procedure. Sterile gloves were not used by majority of the nurses
during the care. They almost never disinfected the catheter hub, and they did not adequately obey the rules after completing the care
procedure.
Conclusions: This study demonstrated that nurses had inadequate skills of central venous catheter care. We recommend that nurses’
skills must be enriched with professional theoretical and practical trainings.
References
- [1] Kurt B. Evidence-based nursing practices to prevent central
venous catheter infections. Journal of Adnan Menderes
University Health Sciences Faculty 2018;2:21-7.
- [2] Hakyemez IN, Yildirmak MT, Cetmeli G, Iris NE. Prevalence,
causative microorganisms, and risk factors of central venous
catheter-related infections in a tertiary care hospital. Abant
Med J 2016;5:108-17.
- [3] Wright MO, Decker SG, Allen-Bridson K, Hebden JN,
Leaptrot D. Healthcare–associated infections studies project:
An American Journal of Infection Control and National
Healtcare Safety Network data quality collaboration: Location
mapping. Am J Infect Control 2018;46:577-8. https://doi.
org/10.1016/j.ajic.2017.12.012.
- [4] Karasu D, Yilmaz C, Durmus G, Ozer D, Caglayan U,
Karaduman I, Asan A. Evaluation of healthcare-associated
infections in critically ill patients receiving long-term
treatment in the intensive care unit. Klimik Journal 2016;
29:71-6. doi:10.5152/kd.2016.17
- [5] Zabidi HAZ, Ali GM, Naqshbandi E. The effect of nurses’
implementation of central vascular catheter maintenance
care bundle on bloodstream infection among ICU patients
in KFGH and KAAUH. International Journal of Nursing
Didactics 2018; 7:10-6. doi: 10.15520/ijnd.v7i12.2153
- [6] Sanli D, Sarikaya A. Evidenced-based nursing care
management at central venous catheters. Journal of the
Turkish Society of Critical Care Nurses 2016;20:84-97.
- [7] Alkubati SA, Ahmed NT, Mohamed ONE, Fayed AM, Asfour
HI. Health care workers’ knowledge and practices regarding
the prevention of central venous catheter-related infection. Am
J Infect Control 2015;43:26-30. doi:10.1016/j.ajic.2014.09.021
- [8] Bati B, Ozyurek P. Knowledge levels of intensive care unit
nurses on central venous catheters. Journal of Medical
and Surgical Intensive Care 2015;6:34-8. doi: 10.5152/
dcbybd.2015.828
- [9] Gnanarani J, Venkatesan L, Manikandan. Effectiveness
of central line bundle care upon the knowledge and
compliance staff nurses in the ICU. International Journal of
Advance Research, Ideas and Innovations in Technology
2018;4:2059-63. https://www.ijariit.com/manuscripts/v4i3/
V4I3-1793.pdf Accessed: June 25, 2019
- [10] Manzo BF, Mariano DR, Ferreira FMC, et al. Knowledge
and behavior of professionals about bundled strategies of
central venous catheter. Rev Bras Enferm 2019;72:50-6. doi:
10.1590/0034-7167-2018-0164.
- [11] Mutlu EY, Senturan L. Effects of hickman catheter care
training on practices of nurses. International Journal of Caring
Sciences 2017; 10 :16-33.
- [12] Ozen N, Kose T, Terzioglu F. Evidence-based practices in the
prevention of central venous catheter infections: Knowledge
of intensive care nurses. Turk J Intensive Care 2020;18:91-8.
doi: 10.4274/tybd.galenos.2019.25991
- [13] Sharour A. Oncology nurses’ knowledge about central line
catheter: caring, complications, and applications among cancer
patients – a cross-sectional study. J Vasc Nurs 2018;36:145-8.
doi:10.1016/j.jvn.2018.04.002.
- [14] Gillespie BM, Polit DF, Hamlin L, Chaboyer W. Developing a
model of competence in the OR: Psychometric validation of
perceived perioperative competence scale-revised. Int J Nurs
Stud 2012;49:90-101. doi:10.1016/j.ijnurstu.2011.08.001.
- [15] Infection prevention and control of healthcare-associated
infections in primary and community care. National Institute
for Health and Care Excellence 2012. https://www.nice.org.uk/
guidance/cg139/resources/healthcareassociated-infectionsprevention-
and-control-in-primary-and-community-carepdf-
351.095.18767045 Accessed:July 11, 2019
- [16] Arslan GG, Ozden D, Alan N, Yilmaz I, Ayik C, Goktuna G.
Examination of nursing drug administration practices via
central venous catheter: An observational study. J Vasc Access
2020;21:426-33. doi: 10.1177/112.972.9819880979.
- [17] Devi R, Ghai S, Singh NV, Puri GD. A methodological study to
develop a standard operational protocol for nurses on central
line catheter care of patients in selected intensive care units.
Indian J Crit Care Med 2017;21:483-7. doi: 10.4103/ijccm.
IJCCM_261_16.
- [18] Gerceker G, Yardimci F, Aydinok Y. Randomized controlled
trial of care bundles with chlorhexidine dressing and advanced
dressing to prevent catheter related bloodstream infections in
pediatric hematology-oncology patients. Eur J Oncol Nurs
2017;28:14-20. doi:10.1016/j.ejon.2017.02.008.
- [19] Marschall J, Mermel LA, Fakih M, et al. Strategies to prevent
central line-associated bloodstream infections in acute care
hospitals. Infect Control Hosp Epidemiol 2014;35:753-71.
doi:10.1086/676533.
- [20] Global Infection Prevention and Control Unit. Evidence of
hand hygiene as the building block for infection prevention
and control. World Health Organization 2017. https://
creativecommons.org/licenses/by-nc-sa/ 3.0/igo. Accessed:
August 4, 2019
- [21] Caner N, Tekinsoy KP. The assessment of the intramuscular
and intravenous drug administration steps of nurses:
Observation study. HUHEMFAD-JOHUFON 2019;6:177-85.
doi: 10.31125/hunhemsire.630812.
- [22] Kazan EE, Gorgulu S. Skills of the nurses about the
administration of subcutaneous low molecular weight heparin
injection. HUHEMFAD-JOHUFON 2009:1-13.
- [23] Acun A, Caliskan N. Evaluation of effectiveness of central
venous catheter related bloodstream infections in the antesty
and reanimation intensive care units of the bundle. Ann Med
Res 2021;28:792-8. doi: 10.5455/annalsmedres.2020.06.587.
- [24] Berman A, Snyder SJ. Kozier& Erb’s fundamentals of nursing,
concepts, process and practice. 10th ed. Pearson, 2015: 814-27.
- [25] Iseri A, Cinar B, Duzkaya DS, , et al. National vessel access
management guide. Turkish Journal of Hospital Infections
2019;23:1-54. http://www.hider.org.tr/global/Dernek_
Kilavuzlari/HID_Damar%20Erisimi%20Rehberi_2019.pdf .
Accessed: August 16, 2019
- [26] Lynn P B. Taylor’s clinical nursing skills. A nursing process
approach. 5th ed. Philadelphia, PA:Wolters Kluwer, 2018: 813-
21.
- [27] O’Grady NP, Alexander M, Burns LA, et al. Guidelines for the
prevention of intravascular catheter-related infections. Clin
Infect Dis 2011;52:162-93. doi:10.1093/cid/cir257.
- [28] Sardan YC, Guner R, Cakar N, et al. Guidelines for the
prevention of intravenous catheter infections. Turkish
Journal of Hospital Infections 2013;17:233-78.http://www.
hider.org.tr/global/Dernek_Kilavuzlari/Damar_ici_Kateter_
infeksiyonlarinin_Onlenmesi_Kilavuzu.pdf. Accessed: July
25, 2019
- [29] Esposito MR, Guillari A, Angelillo IT. Knowledge, attitudes,
and practice on the prevention of central line-associated
bloodstream infections among nurses in oncological care: A
cross-sectional study in an area of Southern Italy. PloS One
2017;12:1-11. doi:10.1371/journal.pone. 0180473.
- [30] Aydogdu S, Akgun M. Determination of knowledge levels
of nurses and the factors affecting the level of knowledge
in central venous catheter care. Clinical Nursing Studies
2020;8:1-9. https://doi.org/10.5430/cns.v8n2p1.
- [31] Preventing central line–associated bloodstream infections:
A global challenge, a global perspective. The Joint
Commission 2012. https://www.jointcommission.org/-/
media/deprecated-unorganized/imported-assets/tjc/
system-folders/topics-library/clabsi_monographpdf.
pdf?db=web&hash=86103821F3C7FF8A7683C933EA0CB391
Accessed: March 7, 2019
- [32] Abdo NM, Fadhli MA. Improving hand hygiene compliance
among healthcare workers in intensive care unit: an
interventional study. Int J Community Med Public Health
2018;5:3747-52.http://dx.doi.org/10.18203/2394-6040.
ijcmph20183558.
- [33] Yurttas A, Kaya A, Engin R. Examination of hospital
infection and hand hygiene compliance in intensive care
unit of a university hospital. Arch Health Sci Res 2017;4 :1-7.
doi:10.17681/hsp.115490.
- [34] Snarski E, Mank A, Iacobelli S, et al. Current practices used for
the prevention of central venous catheter-associated infection
in hematopoietic stem cell transplantation recipients: A
survey from the infectious diseases working party and nurses’
group of EBMT. Transpl Infect Dis 2015;17:558-65. https://
doi.org/10.1111/tid.12399.
- [35] Lai NM, Lai AN, O’Riordan E, et al. Skin antisepsis for reducing
central venous catheter-related infections. Cochrane Database
of Syst Rev 2016;7: CD010140. doi: 10.1002/14651858.
CD010140.pub2.
- [36] Central venous catheter hub cleaning prior to accessing.
Centers for Disease Control and Prevention 2011. https://
www.cdc.gov/dialysis/PDFs/collaborative/Protocol-Hub-
Cleaning-FINAL-3-12.pdf. Accessed: August 20, 2019
- [37] Preventing central line–associated bloodstream infections:
Useful tools, an international perspective, scrub the hub. The
Joint Commission 2013. https://www.jointcommission.org/-/
media/tjc/documents/resources/health-services-research/
clabsi-toolkit/clabsi_toolkit_tool_3-21_scrub_the_hubpdf.
pdf?db=web&hash=79BF0D29BD4AAF13DEC3C3DE5AB90494.
Accessed: August 20, 2019
- [38] Wright MO, Tropp J, Schora DM, Grant MD, Peterson K.
Continuous passive disinfection of catheter hubs prevents
contamination and bloodstream infection. Am J Infect
Control 2013;41:33-8. doi:10.1016/j.ajic.2012.05.030.
- [39] Desra AP, Breen J, Harper S, Slavin MA, Worth LJ. Aseptic
technique for accessing central venous catheters: Applying
a standardized tool to audit ‘scrub the hub’ practices. J Vasc
Access 2016;17:269-72. doi:10.5301/jva.5000509.
- [40] Hosaf S. Investigation of the effectiveness of continuous
education given with internet-mediated communication to
nurses on central venous catheter care management (thesis).
Izmir: Ege Univ; 2019.