ICU护士对中央导管相关血流感染防控的知信行调查及分析

Investigation and analysis of ICU nurses'knowledge,belief and practice on prevention and control of central line associated bloodstream infections

目的了解安徽地区各级医院ICU护士中央导管相关血流感染防控知识、态度、行为现状及影响因素,为预防和控制中央导管相关血流感染的措施提供理论依据.方法2019年6月-7月分层随机抽取安徽地区不同等级的51所医院1050名ICU护士进行中央导管相关血流感染防控知识、态度、行为问卷调查.结果共发放问卷1061份,收回有效问卷1050份,有效回收率为98.96%.中央导管相关血流感染防控知识、态度、行为得分率最高的均为手卫生,分别为74.29%(780/1050)、81.05%(851/1050)、72.38%(760/1050);知识、态度、行为得分率最低的分别是导管的日常评估与维护管理67.81%(712/1050),最大化无菌屏障70.95%(745/1050),输液器、无菌输液接头及附加装置的使用69.71%(732/1050).单因素分析结果显示,不同级别医院、不同类别ICU、不同职称、不同学历、是否感控护士、是否接受培训的ICU护士CLABSI防控知识、态度和行为的得分差异均有统计学意义(P<0.05).经多元逐步回归分析,对中央导管相关血流感染防控知识得分产生显著影响的是本科及以上学历、感控护士和接受培训(P<0.001).结论安徽地区ICU护士中央导管相关血流感染防控知识、态度、行为有待进一步提升.各级医院的ICU应针对本科室中央导管相关血流感染防控的薄弱环节分层次、分岗位、有针对性地加强培训,增强ICU护士的知识储备,端正态度,促进防控行为.

Objective To understand the knowledge,attitude,practice status and influencing factors of central line associated-bloodstream infections prevention and control of ICU nurses at all levels of hospitals in Anhui,so as to provide a theoretical basis for the prevention and control of central line associated-bloodstream infections.Methods From June to July 2019,1050 ICU nurses from 51 hospitals of different levels in Anhui were randomly selected to conduct a questionnaire survey of knowledge,attitudes,and practices about the prevention and control of central line associated-bloodstream infections.Results A total of 1061 questionnaires were distributed,and 1050 valid questionnaires were recovered.the effective response rate was 98.96%.Central line associated-bloodstream infections prevention and control knowledge,attitudes,and practices have the highest hand hygiene scores,74.29%(780/1050),81.05%(851/1050),72.38%(760/1050);knowledge,attitude,the lowest practical scores were 67.81%(712/1050)for daily assessment and maintenance of catheters,70.95%(745/1050)for maximizing sterile barriers,69.71%for use of infusion sets,sterile infusion connectors and additional devices(732/1050).The results of univariate analysis showed that there were statistically significant differences in the scores of central line associated-bloodstream infections prevention and control knowledge,attitudes and practices of different levels of hospitals,different types of ICUs,different titles,different educational backgrounds,whether they were sensory nurses,and whether they were trained ICU nurses(P<0.05).After multiple stepwise regression analysis,it was the bachelor degree or above,the sensory control nurse and the training that had a significant impact on the score of the knowledge of the prevention and control of central line associated-bloodstream infections(P<0.001).Conclusion The knowledge,attitude,and practice of central line associated-bloodstream infections prevention and control of ICU nurses in Anhui area need to be further improved.ICUs at all levels of hospitals should focus on the weak links in the prevention and control of central line associated-bloodstream infections in the undergraduate room,and strengthen the prevention and control training of central line associated-bloodstream infections at different levels and positions,strengthen the knowledge reserve of ICU nurses,and correct attitudes,To promote prevention and control practice.