The Effectiveness of Using CLABSI Prevention-Education Based Intervention on Nurse Competency in Central Line Maintenance and Patient Care Outcomes in Intensive Care Units in Palestine: A Quasi Experimental Study رسالة دكتوراة

Abstract

Central line-associated bloodstream infection (CLABSI) is a serious but preventive hospital-acquired infection. This study aimed to assess the effectiveness of providing an education-based CLABSI prevention intervention on nurses' competency in maintaining central lines and patient mortality rate and length of stay. The study was conducted in intensive care units of the Ministry of Health Hospitals in the northern provinces of Palestine between September 2023 and March 2024. A quasi-experimental design was applied. The sample was convenient and nurses were allocated randomly to either a control group or an experimental group at hospital levels based on the bed capacity of the ICUs from where nurses were recruited. The knowledge was assessed using a translated, self-completed questionnaire. The nurses' skills were observed using a short version of the Ebru Kazan and Gulnur Kar checklist. Regarding the mortality rate and length of stay, a baseline measurement was performed retrospectively for three months before initiating the intervention and then monthly through the study. A total of 98 intensive care nurses were involved in the study. The results indicated that was no significant difference in the baseline knowledge (t = -0.61, p = 0.537) and practice (t = -0.376, p = 0.708) of central lines' safe handling and maintenance between the two groups. The experimental group had their knowledge improved their practice level enhanced and the improvement maintained during the post-intervention period (F (1, 41) = 4485.58, p < 0.001). Regarding the patient outcomes, there was no significant effect of the intervention on the mortality rate (t = -1.85, p = 0.138) and length of stay (t =177, p = 0.151) in both groups. Due to the effect of the educational intervention of this study in improving the intensive care nurses' competencies of central line care, it is recommended to apply ongoing education and in-service training in the infection control field to promote and maintain nurses' competencies of safe handling of central lines and preventing CLABSI. V Also, it is recommended to standardize policies for safe and efficient central line maintenance and Safe handling.