Volume 6, Issue 4 (Autumn 2020)                   JCCNC 2020, 6(4): 231-238 | Back to browse issues page


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1- Department of Pediatric Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran.
2- Department of Nursing, Faculty of Medicine, Qom Branch, Islamic Azad University, Qum, Iran.
3- Nursing Care Research Center, Iran University of Medical Sciences, Tehran, Iran. , borimnejad.l@Iums.ac.ir
4- M.S. in Nursing, Nursing Department, Medical School, Azad University of Qum, Qum, Iran.
Abstract:   (1361 Views)
Background: Neonates require continuous and reliable intravenous routes to receive fluids, intravenous nutrition, and medications; accordingly, repeated interventions are essential to implant these routes. Percutaneous catheterization is a technology used for this purpose. Considering that central line infections are a major concern in neonatal intensive care units (NICUs), the present study aimed to assess the effects of using a care package on the incidence of infections and shelf life of peripheral central catheterization in the premature infants admitted to the NICU.
Methods: This quasi-experimental study was a process assessment research conducted on 131 premature catheterized infants who were admitted to the NICU of Mofid Children’s Hospital affiliated to Shahid Beheshti University of Medical Sciences, Tehran, Iran, in 2019. The study sample included 131 neonates who met the inclusion criteria. The neonates were enrolled in the study at two levels, including 53 subjects in the first four months before the intervention, and 78 in the second four months after application of the care package. The infants were selected via the convenience sampling method. Data were collected using the central line maintenance bundle and central line maintenance bundle daily checklists. The catheter insertion method and the degree of catheter tip infection were evaluated before and after the protocol training program for the nurses. The results of catheter tip culture after removal were considered as the training outcomes. Data analysis was performed in SPSS V. 16, using descriptive statistics, independent t test, the Fisher exact test, and the chi-squared test.
Results: The results of the catheter tip culture confirmed the presence of pathogens in the catheter and culture of 18 samples (34%), before the intervention, while a reduction was denoted in 14 samples (17.9%) after the intervention; the reduction was statistically significant (P=0.036). Furthermore, the shelf life of the catheter increased after the intervention, however, the difference was not significant. 
Conclusion: According to the results, applying the care package reduces the incidence of central peripheral venous catheter infection in neonates admitted to the NICU. Therefore, it is suggested to incorporate this package into the care instructions of neonatal wards.
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● Evidence-based strategies recommend the application of a care package to reduce central catheter infection in NICUs. 
● The present study investigated the effects of applying a care package on the incidence of infection and the shelf life of central peripheral venous catheters, in the premature infants admitted to the NICU. 
● The obtained results indicated that the standard guideline training of nurses could reduce the incidence of central venous catheter infection in infants.
Plain Language Summary 
Low-birth-weight infants often require intravenous access for more than six days. Therefore, a central peripheral venous catheter is considered to be an acceptable alternative to provide long-term access to the vein with few complications and no restrictions on any injections. The nurses who are involved in the implantation of central peripheral venous catheters in infants and children must have sufficient knowledge and experience in the care of this population. The present study aimed to assess the effects of using a care package on the incidence of infections and the shelf life of central peripheral venous catheterization in the premature infants admitted to the NICUs. According to the obtained results, the standard guideline training of nurses reduces the incidence of central venous catheter infection in infants.

Type of Study: Research | Subject: General
Received: 2020/11/23 | Accepted: 2021/02/7 | Published: 2020/11/20

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