Nurses’ compliance with central line associated blood stream infection prevention guidelines: Observational study

Abstract

Objectives: To assess nurses’ compliance with central line associated bloodstream infection (CLABSI) prevention guidelines related to maintenance of the central line and the predictors of compliance. Method: This was an observational study that used a descriptive cross-sectional design. A sample of 171 intensive care unit (ICU) nurses were observed and their compliance was recorded on a structured observational sheet. The study was conducted in the ICUs of 15 hospitals located in 5 cities in Jordan. Data were collected over a 5-month period from March to July 2017. Central lines were all inserted by physicians inside the ICUs. Results: One hundred and twenty participants (70%) showed sufficient compliance. The mean compliance scores were 14.2±4.7 (min=8, max=20); however, the rate of CLABSI was variable across the participating ICUs. Logistic regression with 4 independent variables (years of experience, previous education with CLABSI, nurse-patient ratio and the ICU’s bed capacity) was conducted to investigate predictors of sufficient compliance. The model was significant (χ2(4)=133.773, p=0.00). The nurse-patient ratio was the only significant predictor. Nurses with a 1:1 nurse:patient ratio demonstrated superior compliance over their counterparts with a 1:2 ratio. Conclusion: Further improvement in compliance and patients’ outcomes could be achieved by lowering the nurse-patient ratio.