The article seeks to emphasize the rate of nurse compliance with prevention guidelines regarding central line-associated bloodstream infections (CLABSI). An observational study with a cross-sectional design was conducted on 171 ICU nurses across 15 hospitals in 5 cities. The nurses were assessed on a range of guidelines such as daily assessment of the catheter site, checking and maintaining clean dressing, hand washing and sterile gloves, flushing with saline, changing intravenous sets, and others. The results indicated a 70% sufficient compliance with the evidence supporting the author’s main points. While regression of other factors was conducted, only the nurse-to-patient ratio was a significant predictor, with 1:1 ratio showing much greater compliance than over 1.2, which serves as important information that can be used on the PICOT study that aspects beyond nursing education should be considered. Part of the CLABSI guidelines includes staff education, and the authors emphasize that education and experience would help to improve nurses’ compliance (Aloush & Alsaraireh, 2018). Evidence supports the author’s main points and the flow of the argument. No particular biases or omissions were identified.
Overall, this article is a good exploration of nursing compliance in following guidelines, supporting the concept that educational programs can increase the quality of care and reduce CLABSI. It is a relatively small study, but the sample size is appropriate. The study was performed in Middle Eastern countries, so some assumptions are made in that context, which may have a different approach and conditions when compared to the United States, particularly in terms of nurse-to-patient ratios and other factors that may influence adherence. The takeaway message is that educated and trained nurses generally tend to adhere to the infection prevention guidelines, but there are other factors that also increase or decrease compliance, particularly workload due to patient ratios. Designing my EBP project, I will take into consideration that high compliance may not portray the full picture of the treatment context, and other influences have an effect as well.
Reference:
Aloush, S., & Alsaraireh, F. (2018). Nurses’ compliance with central line-associated blood stream infection prevention guidelines: an observational study. Saudi Medical Journal, 39(3), 273–279.