effect of an educational program in improving venous catheter management practice in pediatric Cairo university hospital ICUs

ABSTRACT

Intravascular catheter related blood stream infection [BSI] is an important cause of illness and excess medical cost. In our hospital, the rate of peripheral venous catheter insertion [cannula] is 61.7% at the intensive care units, and the blood stream infection rate was 35.1% at the beginning of the study. This study was designed to conduct infection control practice training [mainly for cannula insertion practice] at neonatal and pediatric intensive care units of Cairo university pediatric hospital, with evaluation of results before and after the study. The pretest found major problems concerning the proper use of alcohol based product for hand hygiene or during skin preparation for cannula Insertion. Also shortage of infection control knowledge and medical supply [cannula device, soap, alcohol, and sterile dressing] was obvious. A significant improvement after training program was observed regarding proper cannula insertion practice [mainly hand hygiene, skin preparation, and no touch method for cannula insertion], [p value = 0.001]. The blood stream infection rate dropped from 35.1% at pre-implementation period to 23.1% at the post implementation period, with a significant decrease of blood isolates which cause intravascular catheter associated blood stream infection [Coagulase negative staphylococci, Staphylococcus aureues, Candida, and Enterococci] P value 0.004. The significant improvement of cannula insertion practice, together with the decrease of blood isolates related to catheter associated BSI, and the drop of BSI rate after the training pro gram point to the importance of the infection control education program targeted to specific problems