Evaluating the efficacy of a programme to educate nurses on CLABSI linked to total parenteral nutrition administration.

Abstract

There is a major need to improve the knowledge and practice of critical care nurses in India regarding central line-associated bloodstream infection (CLABSI), which is a serious potential complication of total parenteral nutrition (TPN). To develop and validate a skills competency programme; assess knowledge and practice of critical care nurses regarding prevention of CLABSI due to TPN administration; evaluate the effectiveness of the programme; find correlation between knowledge and practice scores. Quasi-experimental: non-equivalent pre-test post-test design. Two hospitals in Meerut, India. 80 nurses (40 in the control group in one hospital, 40 in the experimental group in another hospital). Inclusion criteria: staff nurses from critical care units only, who were present at the time of data collection and willing to participate. Exclusion criteria: staff nurses with <6 months' work experience. Knowledge was assessed using a structured knowledge questionnaire and interpretation scoring. To assess practice, the OSCE (objective structured clinical examination) method was used with four stations and interpretation scoring. The skills-competency programme was delivered to the experimental group only. The post test was conducted with both groups. The post-test knowledge and practice scores in the control group were: mean=12.55; SD=2.57 and mean=21.82; SD= 5.13 respectively. In the experimental group, the post-test knowledge and practice scores were: mean=23.75; SD=1.75 and mean=38.9; SD=2.02 respectively. The unpaired t-test in post-test knowledge between the control and experimental groups was t=22.78, with P=0.0001 at df 39, 0.05 level of significance, 95% CI; for post-test practice the results were, t=19.59, with P=0.0001 at df 39, 0.05 level of significance, 95% CI. Correlation between post-test knowledge and the practice score was r=0.7 (P<0.05), 95% CI. There was a significant difference in post-test knowledge and practice scores, therefore, the skills competency programme was effective. It also highlighted areas that institutions should focus on for effective training and professional development programmes.