Knowledge on CLABSI Prevention Strategies and Associated Factors Among ICU Nurses in Dar es Salaam.

Abstract

Background: Central line-associated bloodstream infection (CLABSI) is one of the major complications for patients with central lines (CLs) and a leading hospital-acquired infection. This infection is associated with increased length of hospitalization, medical costs, high morbidity, and mortality. As primary caregivers for patients with CLs in the ICU, nurses are crucial in preventing CL-related infections and complications. Despite this key role, there is limited knowledge about ICU nurses' understanding of CLABSI, especially in low-income countries like Tanzania. Aim: This study aimed to assess knowledge on CLABSI prevention strategies and associated factors among ICU nurses in Dar es Salaam, Tanzania.

Methods: A quantitative cross-sectional analytical study was conducted among 250 ICU nurses in 3 tertiary hospitals. Data were collected from May to July 2023 using a self-administered questionnaire, with CLABSI knowledge assessed using 32 items. SPSS version 25 was employed to analyze data, and logistic regression was performed to identify factors associated with knowledge of CLABSI prevention strategies. In all analyses, statistical significance was set at a p-value <.05.

Results: The mean knowledge score was 52.2% (SD = 10.7), with a median of 50%. Among the participants, only 52 (28.2%; 95% CI: 22.6%-33.8%) demonstrated a high level of knowledge regarding CLABSI prevention strategies and care. Receiving in-service CL training (AOR = 5.20; 95% CI: 1.79-15.07; p =.002), the availability of CLABSI prevention guidelines (AOR = 2.52; 95% CI: 1.05-6.03; p=.038), and the absence of pre-service CL training (AOR = 3.05; 95% CI: 1.33-6.97; p=.008) were significantly associated with higher knowledge of CLABSI prevention strategies and care.

Conclusion: ICU nurses demonstrated generally inadequate knowledge of CLABSI prevention strategies, with less than one-third (28.2%) showing a high level of knowledge. In-service CL training, availability of CLABSI guidelines, and absence of pre-service training were significantly associated with higher knowledge, suggesting the strong influence of practical, workplace-based learning. Targeted in-service training and consistent provision of evidence-based guidelines are essential to strengthen ICU nurses' competence, reduce CLABSI incidence, and improve patient safety.