Simulation-Based Training for Nurses in Sterile Techniques During Central Vein Catheterization
Methods
This prospective controlled study was conducted in 2009 in a 450-bed urban hospital with 23 medical CCU beds. The experiment took 1 month with a follow-up period of observation of 12 months (Gerolemou et al., 2014). Training simulations took place in an ICU/resuscitation room. The hospital’s institutional review board approved the study. Patient consent was waivered, as the utilization of simulation training was a part of the pre-approved nursing protocol.
The number of participants included 46 CCNs on staff, out of which 42 were fulltime nurses, whereas four were part-time employees (Gerolemou et al., 2014). Every nurse received an individualized review and training regimen based on the initial observations during the trial period. Mean nursing experience for the participant group is 12 years. The least experienced members had 2 years of practice, whereas the most experienced ones capped at 20 years of nursing activity.
Practical instruction was provided using a Laerdal SimMan full body mannequin. It is a standard training apparatus used to train nurses in sterile techniques during CVC (Gerolemou et al., 2014). Nurses were asked to demonstrate their CVC approaches while being observed through a one-way mirror. All sessions were videotaped for training purposes. After the initial assessment, all nurses were reviewed based on their performance, with instructions and the educational material selected based on the perceived shortcomings in sterilization routines.
Use of a Policy-Driven Education Program to Reduce Central Line-Associated Bloodstream Infection Rates
Methods
The study was performed in a 25-bed hospital with a surgical center and an intensive care unit. The participants included 20 outreach physicians, one general surgeon, one radiologist, one pathologist, two physician assistants, and four nurses, out of which two were NPs (nurse practitioners) and 2 – NAs (nurse anesthetists) (Williams, 2015). The intervention involved educating all available personnel on PICC care policies, which included proper sterilization techniques during insertion, scheduled dressing changes, standardized cleaning agents, and site-cleaning frequencies, as well as other policies related to the insertion of central venous catheters and PICCs. The materials included in the educational process involved reviews of current CVC and PICC protocols, CLABSI identification and reduction manuals, and information on using chlorhexidine solution from John Hopkins University Hospital (Williams, 2015). All participants were asked to complete evaluations before and after interventions to assess their knowledge and record any changes that took place. The study also analyzed patients undergoing CVC or PICC treatment in order to determine any changes in infection rates.
Nurses’ Compliance with Central Line Associated Blood Stream Infection Prevention Guidelines
Methods
The design of the study followed a descriptive cross-sectional methodology. Observations were made passively without any attempts to interfere with the process during the follow-up period. Clinical settings involved in this study included 15 hospitals of 5 major Jordanian cities, which included Karak, Mafraq, Zarqa, Irbid, and Amman (Aloush & Alsaraireh, 2018). Ten hospitals were government-funded, four hospitals were private, and one hospital was joined with a university and utilized for educational purposes. All hospitals had intensive care units (ICUs) and implemented catheterization during short-term and long-term care. All ICUs were specialized in adult medical and surgical procedures.
Catheterization was utilized to treat neurological diseases, provide sustenance to victims of road traffic accidents, and treat gastrointestinal deficiencies. Sizes of ICUs varied, as some of them (seven) had fewer than seven beds, whereas the rest exceeded that number. Annual catheterization rates included over 16,000 admissions and 5,000 procedures (Aloush & Alsaraireh, 2018). Observations were made between March and July 2017, lasting over 5 months.
References
Aloush, S. M., & Alsaraireh, F. A. (2018). Nurses’ compliance with central line associated blood stream infection prevention guidelines. Saudi Medical Journal, 39(3), 273-279.
Gerolemou, L., Fidellaga, A., Rose, K., Cooper, S., Venturanza, M., Aqeel, A.,… Khouli, H. (2014). Simulation-based training for nurses in sterile techniques during central vein catheterization. American Journal of Critical Care, 23(1), 40-48.
Williams, D. W. (2015). Use of a policy-driven education program to reduce central line-associated bloodstream infection rates. Journal of Infusion Nursing, 38(1), 63-68.