Management of central venous catheters at the intensive care units in Yemen. Survey of practices

OBJECTIVE: To describe the intensive care units (ICU) current infection control practices regarding the management of central venous catheters (CVCs) in Yemeni hospitals and compare the current practices with the evidence-based guidelines.

METHODS: This study was carried out in ICUs of Sana'a hospitals, Republic of Yemen, in July 2010. We gathered the data regarding the infection control practices associated with CVC management in 25 ICUs of 14 hospitals. A self-administered questionnaire was distributed to ICUs' nurse managers in Sana'a city. The results were analyzed and tabulated using the Statistical Package for Social Sciences software version 11, and compared with the evidence-based guidelines.

RESULTS: Only 44% of units had written policies for CVC management. The 2 most commonly used practices that comply with the guidelines were: wearing of gloves and dressing material. None of the units used 2% chlorhexidine solutions. More than half of the units were adherent to the recommended practice for hand hygiene (before and after insertion, accessing, dressing or replacing/repairing of CVC), preferred insertion site, antimicrobial-coated catheters, aseptic technique during catheter insertion and site care, disinfection of intravenous access ports, capping stopcocks and infusion set tips while they are not in use, and CVC replacement/removal. In all other sections, only the minority were adherent to the recommended practices.

CONCLUSION: There is a diversity of current practices and lack of consistent adherence to the evidence-based guidelines for the prevention of intravascular catheter-related infections.