To Study Effect of Education Programme on Central Venous Site Care Among ICU Nurses in Selected Hospital

Abstract

Background : A central venous catheter, also called a central line, is a long, thin, flexible tube used to give medicines, fluids, nutrients, or blood products over a long period of time, usually several weeks or more, and is one of the important method of treatment. If central venous catheters are not cared for it can result for serious bloodstream infections. These complications worsen patient’s health, prolong hospital stay and increase the cost of care. In practice it has been found that, although hospitals have guide lines for care of central venous catheters, it is not been followed. Operational Definitions:-1. Effect:- According to Oxford dictionary effect means as a change produced by an action or cause. In the study effect refers to the change in the nursing practice of Intensive care unit nurses with relation to central venous site care. 2. Education program:-According to Oxford dictionary education means providing knowledge; instructive or informative. Program means a planned series of future events or actions. In the study education program refers to lecture cum demonstration methods that was used to educate nurses about central venous site care. 3. Central venous site care:-According to medical dictionary a central venous device also known as a central venous catheter, is a catheter placed into a large vein in the neck (internal jugular vein), chest (subclavian vein or axillary vein) or groin (femoral vein). Site is the entry point. Care is the serious attention or consideration applied to doing something correctly or to avoid damage or risk. In the study central venous site care refers to aseptic measures taken to prevent infection of the central venous site. 4. Intensive care unit (ICU):- According to Oxford dictionary :-Intensive care unit is a specialized department of hospital which provides medical treatment with constant attention for a seriously ill patient. In the study it refers to Intensive care unit where critical patients are taken care of. 5. Intensive care unit (ICU) nurse:-According to Oxford dictionary nurse is a person trained to care for the sick or infirm, especially in a hospital.In the study it refers to the nurses working in the Intensive care unit in selected hospital with an experience of 6 months and above. Objective:1. The aim of the study was to assess the practices of ICU nurses with relation to Central venous site care before and after the education programme 2. To associate the practice score of ICU nurses with selected demographic variables. Methods: The study was an experimental pre-test post- test design done on 60 ICU nurses. The tools used for the study were demographic information and observational checklist of 63 items divided in pre-performance, performance and post performance phase. An observation before implementing the education programme was made. After education programme four observations were made. Results: Most of the samples i.e. 48 (80%) of the ICU nurses were in the age group of 23-27 years, 8 (13.3%) were in the age group of 18-22 years and the remaining i.e. 4 (6.7) were in the age group of 28-32 years. Majority of the samples i.e. 31 (51.7%) of the ICU nurses were BSc qualified, 24 (40%) were GNM qualified and remaining 5 (8.3%) were Pb.Bsc qualified. Most of the samples, 26 (43.3%) of ICU nurses had an experience of 0-2years, 27 (45%) had an experience of 2-4 years and the remaining 7 (11.7%) had an experience of 4-6 years. Majority of samples i.e. 41 (68.3%) of ICU nurses had attended doctor's class for Central venous site care, 16 (26.7%) of them had knowledge regarding Central venous site care from seminar, 2(3.3%) of them had attended workshop and 1 (1.7%) of them did not receive any training regarding Central venous site care. In terms of other sources of information 26 (43.3%) of ICU nurses had knowledge from doctors, 17 (28.3%) of them had knowledge from internet, 16 (26.7%) of them had knowledge from senior staff and 1 (1.7%) of them had information from books. After the education programme in pre- performance phase 2 nurses removed ring and ornament, 34 of them removed only wrist watch and 24 of them did not remove ring and ornaments from their hands, 13 nurses had short nails, In performance phase, 44 nurses wore face mask, majority of nurses didn’t wear sterile gloves, before site care 48 nurses performed hand hygiene using soap and water and remaining 12 with water only, 6 nurses followed few steps of hand hygiene and 54 did not follow any steps. All nurses were found to perform hand hygiene for less than 1 minute. For site cleaning it was observed that 56 nurses cleaned 2 inches in diameter around the site with isopropyl alcohol and povidone iodine. In post - performance phase 58 nurses used soap and water for washing hands. Those who did not wash hands with soap and water applied sterilium, 10 nurses followed few steps of hand hygiene and 50 did not follow any steps. All of the nurses performed hand hygiene for less than 1 minute and none of the nurses documented the procedure.