PRACTICE LEVEL AND ASSOCIATED FACTORS TOWARDS CENTRAL LINE CATHETER ASSOCIATED BLOOD STREAM INFECTION PREVENTION PRACTICE AMONG NURSES IN ICU OF PUBLIC HOSPITALS, ADDIS ABABA, ETHIOPIA, 2024

Abstract

Abstract Background: Central venous catheterization, involving inserting a catheter into a vein connected to the heart, is associated with significant morbidity and costs due to central line-associated bloodstream infections. These infections are a major health concern in intensive care units, causing high morbidity, mortality, and economic burden. This is especially true in Ethiopia, where inadequate nurse training and poor protocol adherence exacerbate the problem. Methods: An institutional-based cross-sectional study was conducted among intensive care unit nurses in selected public hospitals in Addis Ababa, 2024. Hospitals were selected using simple random sampling, and 403 intensive care unit nurses working during the data collection period were included. Data were collected via a structured questionnaire and an observational checklist, then analyzed using SPSS version 26. Descriptive statistics summarized frequencies, percentages, and distributions used. To check model of fitness use Hosmer-Lemeshow bivariate and multivariable binary logistic regression analyses identified variables significantly associated with central line catheter prevention practices (p-value < 0.05). Objective: To assess practice level and associated factors towards central line catheter associated blood stream infection prevention practice among nurses in ICU of public hospitals, Addis Ababa, Ethiopia, 2024. Results: Of the 403 intensive care unit nurses approached, 386 participated, yielding a 95.8% response rate. The study revealed that 64.8% of nurses had poor central line catheter prevention practices, while only 35.2% demonstrated good practices. Factors significantly influencing central line catheter prevention practices included knowledge, work experience, educational status, nurse- to-patient ratio, in-service training, and availability of central line catheter guidelines. Nurses with good knowledge (AOR=4.323, 95% CI: 2.515-7.429) and those with a master's degree in critical care (AOR=3.625, 95% CI: 1.990-6.601) were more likely to practice effective central line catheter prevention. Conclusion and Recommendation: Only 35.2% care of intensive care unit nurses in Addis Ababa practiced good central line catheter prevention. Key factors included knowledge, education, experience, nurse-to-patient ratio, training, and guidelines. Improving practices requires regular training, higher education, optimal nurse-to-patient ratios, clear guidelines, monitoring, and continuous learning. Addressing these areas can reduce infections and improve intensive care unit patient outcome. Keywords: Critical care nurse, Central venous catheters, Infection control