Evaluation of Nurses' Competence in the Prevention of Peripheral Intravenous Cannula-Related Infections in Sub-County Hospitals, Eldoret, Kenya

Abstract

Context: Peripheral intravascular cannula, commonly used in inpatient settings for intravenous treatments, are frequently linked to complications such as infections, which can harm patient health and increase healthcare costs.

Aim: This study aimed to evaluate the competence of nurses in the prevention of cannula-related infections in newly upgraded sub-county hospitals.

Methods: An Analytical cross-sectional design was employed across four sub-county facilities, with a quantitative approach used to describe and analyze the knowledge and skills of 86 nurses during the census. Direct observation was also conducted to determine whether nurses applied their theoretical knowledge and skills in practice. A structured questionnaire and observational checklist were used.

Results: The study found that most nurses (87%) demonstrated adequate knowledge, correctly answering≥50% of the 10 knowledge items. The highest awareness was observed in areas such as skin preparation before cannula insertion (100%) and the use of non-sterile gloves and adherence to aseptic technique (97.7%). However, only 36.1% correctly knew the recommended time for cannula removal (12–72 hours), indicating a significant knowledge gap. Most nurses (70%) were skilled in performing intravenous therapy, including inserting, removing, and caring for a peripheral intravenous cannula. The overall competence was 66.3% in nurses who scored >50% in both knowledge and skills. Logistic regression further revealed that nurses with ≥10 years of experience were 1.53 times more likely to be competent (OR = 1.53; 95% CI: 1.36–1.72; p<0.001), and those with 5–9 years had 1.22 times greater odds (OR = 1.22; 95% CI: 1.17–1.81; p=0.050) compared to nurses with <5 years of experience.

Conclusion: The study concluded that most nurses had adequate knowledge, particularly in key infection prevention practices such as skin preparation and aseptic technique. Notable gaps exist in specific areas of knowledge of the recommended cannula dwell time. Nursing experience was significantly associated with higher competence, underscoring the importance of continuous training and mentorship to bridge identified gaps. Enhancing nurses' clinical competence and knowledge in IV cannulation through improved training, regular audits, and interdisciplinary collaboration is recommended. It also highlights the need to bridge the gap between theory and practice to ensure effective infection prevention in the insertion, removal, and care of intravenous cannula.