The reduction of risk in central line-associated bloodstream infections: Knowledge, attitudes, and evidence-based practices in health care workers

Abstract

We set out to acquire information about the knowledge, attitudes, and evidence-based practices associated with the insertion and maintenance of central vascular catheters (CVC) for the prevention of central line-associated bloodstream infections (CLABSI). We selected all health care workers (HCW) in all units using CVCs in the Calabria region of Italy. Correct answers about the knowledge of physicians and nurses ranged from 43% to 72.9% and were significantly higher in respondents who worked in intensive care unit (ICU) wards in hospitals that had a written policy about CVC maintenance and had active formal training. Respondents' attitudes toward general aspects of CLABSI prevention were very positive and were significantly higher for HCWs working in regional general hospitals, practicing in ICU wards, and having appropriate knowledge. Concerning HCWs, 83.9% reported that, if patients had any manifestations suggesting local or bloodstream infection, the dressing was removed for assessment purposes; this practice was significantly more likely to occur in HCWs having appropriate knowledge and positive attitudes and who worked in hospitals with a written policy about CVC maintenance. The study demonstrated that written policies, formal training, and years of experience contributed to an increase in knowledge, practice, and positive attitudes toward CLABSI prevention. In addition the paper demonstrates how great this need is, having reported many non-evidence-based practices still continuing despite new evidence.