Abstract Central venous access devices (CVADs) have become essential interventions for pediatric patients. However, their use is associated with serious complications. The most common and potentially preventable complication is catheter related blood steam infections (CRBSIs). Despite the implementation of interventions that have been shown to decrease their risk, CRBSIs still occur. Pediatric nurses were surveyed regarding their knowledge and application of recommended CVAD care practices, and their perspectives on possible factors that could contribute to the incidence of CRBSIs. Donabedian’s (1966) Structure-Process-Outcome Model guided the study. A cross-sectional, descriptive and exploratory mixed-methods survey design was used. The convenience sample consisted of 93 pediatric nurses. Findings indicate areas of concern related to adherence to CVAD care guidelines and situations that could interfere with the provision of recommended CVAD care. The primary factor identified was the use of improper technique by members of the healthcare team and the patients’ families.

Central line associated bloodstream infections (CLABSIs) are one of the most fatal types of healthcare associated infections (HAIs) and their economic impact is significant. Although some studies have found no signification reduction in CLABSI rates with chlorhexidine gluconate (CHG) bathing; good evidence exists to support the use of CHG bathing as an intervention to reduce CLABSIs (Bleasdale et al., 2007; Climo et al., 2009; Climo et al., 2013; Montecalvo et al., 2012). CHG bathing performance may influence the effectiveness of the CHG bathing protocol. The purpose of this study was to determine the effect of a targeted educational approach involving simulation on the delivery by nursing assistants of a CHG bathing protocol. The study aims were (1) to compare the effectiveness of removal of simulated skin microbes by nursing assistants who receive training for a CHG bathing protocol with simulation training to simulated skin microbe removal by nursing assistants who receive training for a CHG bathing protocol without simulation training and (2) to examine the influence of a demographic factor, years of practice as a nursing assistant on the percentage of simulated microbes present following performance of bathing. Thirty nursing assitant volunteered for this study and were randomized to either the intervention group (training for a 2% CHG cloth bathing protocol with simulation training) or the control group (training for a 2% CHG cloth bathing protocol without simulation training). For aim (1) an independent t-test (inferential tests of group differences) was used to examine if there was any difference between the intervention group and the control group on the percentage of microbes remaining on the mannequin post bathing. For aim (2) a Pearson correlation was computed to assess the relationship between years of practice as a nursing assistant and the percentage of microbes remaining post bathing. Results showed no statistically significant differences between the two groups on demographc factors. For aim (1) the t-test revealed a statistically significant (p < .001) difference between the intervention group and the control group on the percentage of simulated microbes remaining on the mannequin post bathing. For aim (2) there was no correlation between the years of practice as a nursing assistant and the amount of microbes left on the mannequin post bathing (p=.709). This study provided an innovative method of assessing the percentage of simulation microbes remaining on the mannequin and made it possible to quantitatively measure bathing performance. Monitoring the compliance with CHG bathing is an important component when evaluating the effectiveness of a CHG bathing protocol. The findings of this study suggest that simulation training was an added benefit to the nursing assistants who received it, as they performed better than those who did not receive simulation training.