Comparison of the efficiency of standard care and transparent film drapes used in central venous catheter care

This study was carried out to compare the effectiveness of standard care used in central venous catheter (CVC) care and transparent film dressings containing chlorhexidine gluconate in terms of catheter infection, cost of care, nurse satisfaction and efficiency. The subjects of the study are the patients hospitalized in Bolu province, İzzet Baysal State Hospital, Köroğlu Unit, General Intensive Care Unit, and the nurses working in this unit. In the non-randomised, parallel controlled study, standard CVC care was applied to the control group between March-August 2020; on the other hand, catheter care with transparent film dressings containing chlorhexidine was applied to the experimental group between September-December 2020. Data were collected by the researcher from patient files, nurse observation forms, face-to-face interviews with nurses, and surveillance information from the infection control committee. Data analysis was performed via a statistics program. The rate of CVC use was found to be 0.66 in the experimental group and 0.55 in the control group. Although the rate of CVC usage in the experimental group was higher than the control group (p<0.05), no development of central venous catheter-related bloodstream infection (CRBSI) was observed. While the rate of infection was found to be 3.4/1000 catheter days in the control group and 0/1000 catheter days in the experimental group, the difference was not statistically significant (p>0.05). Arterial puncture was seen in 2 patients in the experimental group and in 1 patient in the control group. In total, 77 dressings were applied to the experimental group and 293 were applied to the control group. It was observed that more dressing was performed in the control group due to routine change, dirt, and loosening than in the experimental group; and in the experimental group, more dressing was performed due to wetness compared to the control group Transparent film dressings containing chlorhexidine gluconate, which can stay in CVC care/dressing for up to 7 days, were found to decrease the CRBSI ratio (p>0.05), and increase nurse satisfaction and productivity (p<0.05); but it was detected that they are not cost-effective (p<0.05). It was recommended that long-acting transparent film dressings containing chlorhexidine gluconate and CVC care should be used only in patients with critical clinical conditions and at high-risk; and that routinely, cost-effective transparent film dressings should be used rather than standard care.