Effects of a Care Package on the Shelf Life and Incidence of the Infection of Central Peripheral Venous Catheter in the Premature Infants Admitted to the NICU

Abstract

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.

Keywords

• central vein
• infection
• neonatal
• critical care
• peripheral catheterization