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Centers for Disease Control and Prevention guidelines for preventing central venous catheter-related infection: Results of a knowledge test among 3405 European intensive care nurses*

Labeau, Sonia O. MNSc; Vandijck, Dominique M. MSc; Rello, Jordi PhD; Adam, Sheila MNSc; Rosa, Ana RN; Wenisch, Christoph MD; Bäckman, Carl RN; Agbaht, Kemal MD; Csomos, Akos PhD, DEAA; Seha, Myriam RN; Dimopoulos, George MD, PhD, Fccp; Vandewoude, Koenraad H. PhD; Blot, Stijn I. PhD; for the EVIDENCE Study Investigators

Critical Care Medicine:
doi: 10.1097/CCM.0b013e3181926489
Brief Reports
Abstract

Objective: To determine European intensive care unit (ICU) nurses’ knowledge of guidelines for preventing central venous catheter-related infection from the Centers for Disease Control and Prevention.

Design: Multicountry survey (October 2006-March 2007).

Setting: Twenty-two European countries.

Participants: ICU nurses.

Measurements and Main Results: Using a validated multiple-choice test, knowledge of ten recommendations for central venous catheter-related infection prevention was evaluated (one point per question) and assessed in relation to participants’ gender, ICU experience, number of ICU beds, and acquisition of a specialized ICU qualification. We collected 3405 questionnaires (70.9% response rate); mean test score was 44.4%. Fifty-six percent knew that central venous catheters should be replaced on indication only, and 74% knew this also concerns replacement over a guidewire. Replacing pressure transducers and tubing every 4 days, and using coated devices in patients requiring a central venous catheter >5 days in settings with high infection rates only were recognized as recommended by 53% and 31%, respectively. Central venous catheters dressings in general are known to be changed on indication and at least once weekly by 43%, and 26% recognized that both polyurethane and gauze dressings are recommended. Only 14% checked 2% aqueous chlorhexidine as the recommended disinfection solution; 30% knew antibiotic ointments are not recommended because they trigger resistance. Replacing administration sets within 24 hrs after administering lipid emulsions was recognized as recommended by 90%, but only 26% knew sets should be replaced every 96 hrs when administering neither lipid emulsions nor blood products. Professional seniority and number of ICU beds showed to be independently associated with better test scores.

Conclusions: Opportunities exist to optimize knowledge of central venous catheter-related infection prevention among European ICU nurses. We recommend including central venous catheter-related infection prevention guidelines in educational curricula and continuing refresher education programs.

Author Information

From the Faculty of Healthcare Vesalius (SOL, KHV, SIB), University College Ghent, Ghent, Belgium; Faculty of Medicine and Health Sciences (SOL, KHV, SIB), Ghent University, Ghent, Belgium; Intensive Care Department (JR), Joan XXIII University Hospital, University Rovira and Virgili, CIBER Enfermedades Respiratorias, Tarragona, Spain; Specialist Hospitals (SA), University College London Hospitals Trust, London, United Kingdom; Intensive Care Department (AR), Hospital Garcia de Orta, Almada, Portugal; Medizinische Abteilung mit Infektions und Tropenmedizin (CW), SMZ-Süd-Kaiser Franz Josef Spital, Vienna, Austria; Department of Anaesthesia and Intensive Care (CB), Vrinnevisjukhuset, Norrköping, Sweden; Intensive Care Unit (KA), Hacettepe University, Ankara, Turkey; Surgical Intensive Care Unit (AC), Semmelweis University, Budapest, Hungary; Intensive Care Unit (MS), Spital Maennedorf, Maennedorf, Switzerland; Intensive Care Department (GD), University Hospital “Attikon,” Medical School, University of Athens, Athens, Greece; and General Internal Medicine and Infectious Diseases (SIB), University Hospital Ghent, Ghent, Belgium.

Supported, in part, by a doctoral research grant from Ghent University College, Ghent, Belgium; D. Vandijck is supported, in part, by a doctoral grant from the Special Research Fund of Ghent University, Ghent, Belgium; project supported in part by CIBERes o6/o6/036 (J. Rello).

The authors have not disclosed any potential conflicts of interest.

For information regarding this article, E-mail: sonia.labeau@hogent.be

© 2009 by the Society of Critical Care Medicine and Lippincott Williams & Wilkins