Nurses’ knowledge, attitude, and practice in peripherally inserted central catheter-related thrombosis prophylactic practices: A multicentric cross-sectional study

Peripherally inserted central catheter (PICC)-related thrombosis is preventable, and nurses play a play a crucial role in its prevention. The implementation of nurses' preventive practice is key to reducing the occurrence of PICC-related thrombosis. The level of nurses' knowledge, attitude, and practice can influence the prevention of PICC-related thrombosis, which is important for reducing patient suffering. The aim of this study was to assess nurses' knowledge, attitude, and practice level regarding PICC-related thrombosis prevention based on evidence-based guidelines. Data were collected using a self-designed anonymous electronic questionnaire, which measured nurses' scores in knowledge, attitude, and practice level of PICC-related thrombosis prevention. The study included 5544 clinical nurses who were in contact with the maintenance department of PICC in tertiary general hospitals in 5 regions of China. The scores of nurses' knowledge, attitude, and practice in all dimensions of PICC-related thrombosis prevention belonged to a non-normal distribution. Approximately 55.01% of nurses achieved or exceeded the median knowledge score of 15 (range 0-20) with an accuracy rate of 75%. Knowledge regarding the assessment of risk factors, signs and symptoms, and extubation and treatment was limited. Additionally, 61.99% of nurses had attended continuing education training courses. More than 97% of nurses had a positive attitude towards preventing PICC-related thrombosis, with only 76.79% having a strong positive attitude. Over 58% of nurses did not always perform well in risk factor assessment. Furthermore, there was a significant positive correlation between nurses' knowledge, attitude, and practice scores in PICC-related thrombosis prevention. Chinese nurses demonstrated enthusiasm for PICC-related thrombosis prevention. The findings of this study highlight the need to improve the knowledge, attitude, and practice of nurses in PICC-related thrombosis prevention. It was observed that nurses had weak practice enthusiasm in risk factor assessment, which corresponds to the low correct rate in answering certain some risk factor assessment items of knowledge dimension. Therefore, more attention should be devoted to the aspect of assessment of risk factors, signs and symptoms, and extubation and treatment, including the update of the content and diversifying the training forms. Further research should explore the reasons for these findings from multiple perspectives.