RESUMEN
BACKGROUND: The risk of central line-associated bloodstream infections (CLABSIs) increases when preventive guidelines are not adhered to. However, studies have generally been quantitative and aimed at determining the effectiveness of CLABSI prevention bundles. Few studies have used a mixed-methods approach to investigate nursing professionals' knowledge and practices regarding CLABSI prevention. PURPOSE: To determine nursing professionals' knowledge and practices regarding CLABSI prevention and identify facilitators and barriers to adherence to CLABSI prevention strategies in a Brazilian neonatal intensive care unit. METHODS: A mixed-methods approach was used. Nursing professionals answered questionnaires regarding knowledge and practices surrounding CLABSI prevention. Semistructured interviews explored barriers nursing professionals face that hinder adherence to CLABSI preventive practices. FINDINGS: Nursing professionals had moderate knowledge regarding CLABSI prevention practices. Daily assessment of the continued need for central venous lines (CVLs), hub disinfection before and after handling, and hand hygiene before handling CVLs were practices less adhered to. Interviews revealed barriers to adherence to preventive practices included lack of adequate equipment, resources for hand hygiene, and inadequate physical structure. Increased education and awareness of safe CVL practices and accountability of the entire healthcare team may improve adherence to CLABSI prevention practices. Results of this study reinforce the importance of considering current nursing practices when developing strategies to increase adherence to CLABSI prevention guidelines. IMPLICATIONS FOR PRACTICE: Providing continuing education may increase adherence to CLABSI prevention strategies. IMPLICATIONS FOR RESEARCH: Research is needed to develop strategies aimed at increasing nursing adherence to CLABSI prevention strategies.
