Central Venous Catheter Care Training for Pediatric Oncology Nurses

Training in Central Venous Catheter Care: Effects on Knowledge and Infection Prevention Behaviors of Pediatric Oncology Nurses

The knowledge level of nurses regarding care techniques plays a crucial role in the prevention of central venous catheter-related infections. This study was designed to evaluate the effect of training on central venous catheter care (CVCC), provided to nurses caring for pediatric oncology patients, on their knowledge level and infection prevention behaviors. The study aims to determine the effectiveness of an educational program intended to enhance nurses' knowledge and practical skills in preventing CVC-related infections, thereby contributing to evidence-based practices that improve patient safety.

Quasi-experimental, pre-test/post-test desing with a control group. Central catheters are frequently used in hematology and oncology clinics. They are invasive devices employed in hospitalized patients for fluid therapy, drug administration, blood transfusions, total parenteral nutrition, and hemodynamic monitoring. In addition to enabling the effective continuation of treatment, they provide patients with a more comfortable therapeutic experience.

Proper maintenance of catheters is crucial for treatment continuity. Despite their medical advantages, central venous catheters (CVCs) are associated with complications such as infection, hemorrhage, and thrombosis. When central venous catheterization and catheter care are performed by inexperienced personnel or teams, the risk of catheter colonization and infection increases. Furthermore, if the catheter remains in place for more than five days, the risk of infection is eight times higher in groups using gauze dressings and microporous tape.

CVC-related infection is a significant cause of morbidity and mortality in immunocompromised children and adults, with infection-related mortality estimated between 12% and 25%. Recent studies have demonstrated that standardization of aseptic techniques and the provision of regular training reduce the risk of infection, while catheter insertion and maintenance by inexperienced personnel increase the likelihood of colonization or infection.

Nurses are key personnel both during central venous catheter insertion and in ensuring catheter care is maintained with aseptic technique . Regular training of healthcare professionals responsible for catheter insertion and care, ensuring compliance with hand hygiene, and adopting maximum barrier precautions during insertion (use of sterile gloves, gown, sterile drape covering the insertion site, mask, and cap) are recommended. In addition, the use of >0.5% chlorhexidine-alcohol combinations for skin antisepsis, routine use of chlorhexidine/antiseptic-impregnated catheters, and chlorhexidine-impregnated dressings are advised.

There are various nursing care practices aimed at preventing CVC-associated infections. It has been recommended that healthcare professionals conduct high-level evidence clinical studies to evaluate the effectiveness of these practices on infection, develop clinical protocols that may serve as guidelines for CVC care, and monitor these protocols regularly. Many healthcare institutions provide not only initial training for newly employed staff but also refresher training for existing personnel. Since aseptic techniques are complex, nurses need to complement their education with practical training to strengthen their knowledge and skills. CVC-associated infections remain an important risk factor; however, with properly planned training, nurses' knowledge of current guidelines and their compliance with them should be periodically evaluated . Educational programs provided to nurses should be didactic, evidence-based, and structured with appropriate content and timing.

Nursing is an applied profession that requires meaningful integration of theoretical knowledge and practical skills. Therefore, this study was designed to evaluate the effect of theoretical and practical training on central venous catheter care, provided to nurses caring for pediatric oncology patients, on their knowledge level and infection prevention behaviors.

Inclusion Criteria:

• Provided care to a pediatric oncology patient at least once
• Performed a procedure via a central venous catheter on a pediatric oncology patient
• Voluntarily signed the informed consent form

Exclusion Criteria:

• Not having previously performed a procedure via a central venous catheter