Factors Affecting Central Venous Catheter’s Dwell Time in Critically Ill Patients: Suggested Guideline

Abstract

Background: Central venous catheter (CVC) is a hollow tube that provides reliable vascular access in critically ill patients. The dwell time of the catheter is ample, limited by presence of complications-related factors. Nursing care regarding central venous catheter is very important to prevent complications and increase the central venous catheter’s dwell time. Aim: Assess the factors affecting central venous catheter’s dwell time in critically ill patients with suggested guideline. Design: A descriptive exploratory design was utilized in this study. Setting: This study was conducted at the combined medical intensive care unit at Ain Shams University Hospital. Study subjects: A convenient sample of all nurses (32 nurses), all available physicians (22 physicians) working in the previous mentioned setting and all available patients connected with central venous catheter (84 patients). Data collection tools: Four tools were used for data collection; 1) Patient-related factors assessment questionnaire. 2) Nurse-related factors assessment tools containing knowledge assessment questionnaire and central venous catheter nursing care observational checklists. 3) Central venous catheter insertion observational checklist for physicians. 4) Environmental related-factors assessment tool. Results: more than one third of the studied patients had secondary education, more than two thirds of the studied nurse had unsatisfactory level of total knowledge regarding central venous catheter care, more than half of them had satisfactory level of total practice regarding its care and more than three quarters of the studied physicians had satisfactory level of practice regarding insertion of central venous catheter. Conclusion: The factors affecting central venous catheter’s dwell time were patients’ level of education, nurses’ experience, their total knowledge and total practice and physicians’ experience and practice. Recommendations: In-service training program must be developed based on need assessment for nurses in relation to care of central venous catheter.