Nurses' Knowledge and Behavior in Hospitals Regarding the Prevention of Central Line-Associated Bloodstream Infections: A Systematic Review.

Abstract

Introduction: Central line-associated bloodstream infections (CLABSI) are a significant source of hospital-acquired infections, particularly in intensive care units where central venous catheters are frequently used. These infections can lead to increased morbidity, mortality, and healthcare costs. While various clinical guidelines exist for prevention, the actual knowledge and adherence of nurses to these guidelines vary widely, with limited synthesis available at the systematic review level.

Aim: This study aimed to synthesize current evidence on the knowledge, behaviors, and adherence of intensive care unit nurses regarding CLABSI prevention practices.

Methods: This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Peer-reviewed empirical studies published between 2018 and 2024 were searched in PubMed, Scopus, and Google Scholar. Studies were included if they assessed ICU nurses' knowledge and practices related to CLABSI prevention. After screening 3,585 articles, nine studies met the inclusion criteria and were appraised using the Risk of Bias in Systematic Reviews (ROBIS) tool.

Results: Nine full-text studies published between 2018 and 2024 were analyzed. The studies used cross-sectional surveys, cohort designs, and questionnaire validation methods. Most nurses demonstrated moderate knowledge levels, but adherence to prevention guidelines was low, with full compliance reported by only 5% of participants. Key themes included training gaps, institutional variability, and increased infection risk from improper catheter use. Several studies suggested that targeted education and the use of diagnostic tools such as procalcitonin may support improved outcomes.

Conclusion: This review highlights a persistent gap between knowledge and adherence to CLABSI prevention practices among ICU nurses. Strengthening education, institutional support, and diagnostic strategies is essential to reduce infection rates and improve patient safety.