Knowledge and Practices Regarding Prevention of Central Venous Catheter Removal-Associated Air Embolism: A Survey of Nonintensive Care Unit Medical and Nursing Staff.

Introduction: Air embolism is a potentially serious complication of central venous catheter (CVC) use. While CVC insertion is usually performed by a trained specialist, extraction is frequently the responsibility of junior staff members. This complication can be easily prevented by following several simple measures described in common guidelines.

Aim: We conducted a single-center survey to assess knowledge and practices concerning the prevention of air embolism associated with CVC removal among healthcare workers from nonintensive care units.

Methods: The correct answers to the questionnaire were determined according to best-practice recommendations for CVC removal. Based on a comparison of the total sum of correct answers between the categories of groups, factors that predicted the level of knowledge were identified using an independent sample t test.

Results: Of the 156 respondents, one-third were unfamiliar with air embolism as a complication of CVC extraction. Almost 80% were unaware of the existence of a CVC removal protocol. Almost half of respondents did not follow guidelines regarding patient position when removing a CVC, 72% did not ask the patient to perform the Valsalva maneuver during the procedure, and 54% did not ask the patient to remain supine after the procedure. Adherence to the protocol was correlated with professional experience, with a lower level among those with experience of less than 1 year and, particularly, among interns.

Conclusions: Our survey revealed inappropriately low awareness of CVC removal-associated air embolism risk and low familiarity with CVC removal best-practice recommendations among nonintensive care unit healthcare workers. Staff members with experience of less than 1 year, including interns, were found to have a lower level of knowledge. These findings emphasize the importance of development and distribution an internal hospital protocol and the integration of educational intervention into a preliminary internship program.