ASSESSMENT KNOWLEDGE AND PRACTICES OF INTENSIVE CARE UNIT NURSES REGARDING CENTRAL LINE CATHETER CARE AT AL-THAWRA HOSPITAL IN SANA'A CITY-YEMEN

Abstract

Background of the study: Central venous catheters are often used as mandatory devices when caring critically ill patients for administration of drugs as well as nutrients and continuous assessment of the cardiovascular system. Adequate knowledge of nurses in taking care of central venous pressure line plays vital role to minimize complications such as infections and hemorrhages and to accurately recognize catheter-related problems, thus securing safer and improved outcome for the patient. Catheter-related blood stream infections are associated with significantly increased morbidity, mortality, and expenditures. Advanced practice nurses possess the power to influence catheter-related line infections in their critical care units. Understanding current recommendations for catheter material selection, site selection, site preparation, and site care can affect rates of catheter-related bloodstream infections.

General objective: The general objective of this study was to assess knowledge and practice of nurses in intensive care units for central line catheter care.

Methodology: A descriptive cross-sectional study was conducted among ICU nurses at Al-Thawra hospital in Sana'a City-Yemen, to assess knowledge and practice of ICU nurses regarding central line catheter care. The sample of the study consisted of 102 Yemeni nurses from different ICU Al-Thawra hospital were participated in this study. The sample size was determined using EpiCalc 2000. A stratified sample random sampling was applied to select the sample size from different ICU Al-Thawra hospital. After official approvals were obtained from the previously selected settings, the researcher obtained lists of nurses' currently working in the study settings via random sampling methods. Data was collected using a close-ended questionnaire, and observation (checklist) 102 nurses were tested for knowledge and practice by using an observational checklist. Information letters, consent form, and questionnaires were handed to ICU nurses by the researcher. Data coded and entered into SPSS version 21.0 for descriptive and inferential statistics.

Results: ICU nurses, (67%) were female, (58.8%) were unmarried belonged to age group (20-29years) 49% with age mean ± SD, 29.98 ± 5.53 years. About (52 %) had working experience from 1-5 years. Two third (68.6 %) the nurses had a diploma degree, (64%) had no courses training in ICU and (92%) had no training program on central line catheter care, also, (91%) had no training program on central line catheter care infection control. Knowledge scored and their levels were as follows: (0.0%) scored 76%-100%, good, (29.4%) scored between 50%-75% and (70.6%) scored between 0% - 49%. poor knowledge toward central line catheter care. The overall level of practice, (91.1%). of nurses had a poor level, (7.8%) had a moderate level and (0.98%) that were had a good level of practice. No association between knowledge level toward central line catheter care and demographic characteristics data regarding age (P-value= 0.75), sex (P-value=0.17), marital status (P-value=0.98), education level of (P-value=0.47), years' experience (P-value=0.99), and training course of ICU, CVC, infection control for CVC (P-value=0.08, 0.27, 0.62 respectively). ICU nurses’ practice level toward central line catheter care was no statistically associated with demographic characteristics data regarding age (P-value= 0.69), sex (P-value=0.46), marital status (P-value=0.46), education level of (P-value=0.91), years' experience (P-value=0.51), and training course of ICU, CVC, infection control for CVC (P-value=0.75, 0.66, 0.87 respectively).

Conclusion: ICU nurses’ knowledge of central line catheter care was inadequate, and their practice was found to be poor. No association between knowledge and demographic characteristics data. ICU nurses’ practice on central line catheter care was not statistically associated with demographic characteristics data.

Recommendations: We recommended increasing knowledge and practice of intensive care unit nursing staff through the courses training, workshop, and curriculums. In addition to similar studies with large sample size in other hospitals that provide critical care in Yemen are recommended. Further research should be conducted to test knowledge and practice levels of nurses prior to and after the educational program on evidence-based guidelines for central line catheter care .