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BACKGROUND: Central venous catheter-related bloodstream infections (CLABSIs) are a significant concern in intensive care units (ICUs) as they lead to increased morbidity, mortality, and healthcare costs. Fortunately, these infections are largely preventable through strict adherence to CLABSI prevention guidelines. Nurses play a critical role in preventing CLABSIs. AIM: This study aimed to investigate factors affecting critical care nurses' knowledge, attitudes, and perceived barriers related to implementing CLABSI prevention guidelines, and to predict factors influencing compliance with these guidelines. METHODS: This cross-sectional study was conducted from April to May 30, 2023, with a convenience sample of 470 critical care nurses from ICUs across eight hospitals in Sana'a, Yemen. Data were collected using an observational checklist and self-administered questionnaire. Descriptive statistics, Independent Student's t-test, one-way ANOVA, Pearson's correlation coefficient, multiple linear regression, and multilayer perceptron neural networks were performed. RESULTS: Critical care nurses exhibited low knowledge of CLABSI prevention guidelines, with compliance reaching an acceptable level. Despite the higher perceived barriers, the nurses demonstrated a positive attitude. Nurses with greater knowledge and positive attitudes displayed higher compliance levels. However, perceived barriers were negatively associated with knowledge and compliance. Notably, multilayer neural network analysis identified knowledge and perceived barriers as the strongest predictors of nurses' compliance. CONCLUSION: The current findings emphasize the need for multifaceted strategies to implement the CLABSI prevention guidelines. These strategies should address knowledge gaps, support positive attitudes, and address practical barriers faced by nurses to ensure successful implementation of CLABSI prevention.
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Background: A continuous and high frequency of alarms from monitoring and treatment devices can lead to nurses' sensory exhaustion and alarm fatigue in critical care settings. Aim: The purpose of this study was to evaluate the level of alarm fatigue and determine the relationship between nurses' sociodemographic and work-related factors and the level of alarm fatigue in critical care settings in Hail City, Saudi Arabia. Methods: Between May and July 2023, 298 nurses who worked in the emergency, intensive care, and critical care units of all the public hospitals in Hail City participated in a cross-sectional survey. Sociodemographic and work-related sheet and the Nurses' Alarm Fatigue Questionnaire were used to collect data. Results: The total mean score of alarm fatigue was 26.38±8.30 out of 44. The highest score was observed for the item "I pay more attention to the alarms in certain", while the lowest score were observed for the items "I turn off the alarms at the beginning of every shift" with mean scores of 2.51 and 1.61, respectively. Nurses who were males, older than 30 years and Saudi citizens had significantly higher mean scores of alarm fatigue than their counterparts. In addition, significantly higher mean scores of alarm fatigue were noticed for nurses experienced for 10 years or more and who had regular morning shifts. Multiple linear regression showed that male (p=0.014), age (p=0.012), and Saudi nationality (p <0.029) were the independent factors affecting the level of fatigue alarm among nurses. Conclusion: Nurses working in critical care settings at hospitals in Hail city are exposed to average levels of alarm fatigue, which can be influenced by sex, age, nationality, and experience of nurses. Therefore, it is imperative to manage alarm fatigue in critical care units by considering work-related and personality-related factors to ensure patient safety.
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BACKGROUND: Catheter-associated urinary tract infection is a global problem but it can be prevented with the appropriate implementation of evidence-based guidelines. This study was conducted to assess the level of compliance of healthcare workers with the catheter-associated urinary tract infection prevention guidelines during the insertion of a urinary catheter. METHODS: An observational study using a descriptive cross-sectional design was conducted at Sana'a City hospitals, Yemen. All the nurses and physicians from the governmental, teaching, and private hospitals were eligible to participate in the study. The data collection was performed through convenience sampling from March 2020 to December 2020, using a structured observational checklist prepared specifically for this study. RESULTS: The majority of the urinary catheter insertions were performed by nurses. There were no written policy or procedures for an urinary catheter insertion and no in-service education or training departments in the majority of the hospitals. The overall mean score of compliance was 7.31 of 10. About 71% of the healthcare workers had a high or acceptable level of compliance and 29% had an unsafe level of compliance. Compliance was low for maintaining aseptic technique throughout the insertion procedure, using a single use packet of lubricant jelly, performing hand hygiene immediately before insertion, and securing the urinary catheter once inserted. Factors affecting the healthcare workers compliance were gender, the working ward/unit of the healthcare workers, the availability of a written policy/procedure and a department or unit for in-service education. CONCLUSION: Yemeni healthcare workers' overall compliance was acceptable but it was unsafe in several critical measures. There is an urgent need for developing, implementing, and monitoring national guidelines and institutional policy and procedures for catheter-associated urinary tract infection prevention. Periodical in-service education and training programs and adequate access to the necessary materials and supplies are paramount.