الفهرس 
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Abstract
Summary
Arterial line is an invasive technique that involves inserting a catheter or cannula into arteries such as the femoral, brachial, or radial arteries, among others. An arterial catheter can be accessed for therapeutic such as selective thrombolysis, stenting, and embolization as well as diagnostic such as repeated arterial blood gas analysis, or ABG purposes (Shaikh et al., 2022).
According to Vaismoradi et al., (2020) Critical care Nurses play a pivotal role in ensuring safe patient care because critical care nurses adhere to protocols for the management of critical illness. In addition to placing a high priority on patient safety, nurses have a legal and ethical duty to follow safety protocols; failing to do so could have negative legal repercussions as well as reputational implications for healthcare organizations. Compliance to arterial line safety guidelines is not only legal but also helps to reduce adverse occurrences and maintain continuity of care. In essence, compliance to arterial line safety guidelines is integral to providing high-quality healthcare, fostering a culture of safety, and ensuring the well-being of both patients and healthcare professionals (Yuan et al., 2022).
Aim of the study:
The present study aimed to assess nurses’ compliance with safety measures of arterial line through the following:
Assess nurses’ knowledge with safety measures of arterial line.
Assess nurses’ compliance toward practices of arterial line safety measures.
Assess factors affecting nurses’ compliance regarding application of arterial line safety measures.
Research Question:
This study was conducted for answering the following questions:
What is nurses’ knowledge with arterial line safety measures?
What is the level of nurses’ compliance with arterial line safety measures?
What factors affecting nurses’ compliance with arterial line safety measures?
Subjects and Methods
Research design:
A descriptive exploratory design was utilized to meet the aim of this study and to answer the research question.
Setting:
This study was conducted in three ICU units the open-heart intensive care unit, chest intensive care unit and cardiac care unit (CCU) at Academy of Heart which affiliated to Ain shams University Hospitals, Cairo governorate, Egypt.
Subjects:
A convenient sample of all the available nurses 76 working in the above mentioned setting; 31 working in Open-heart intensive care unit, 27 in Chest intensive care unit and 18 in Cardiac care unit regardless their characteristics such as, age, gender, qualifications and experiences in the previously mentioned setting and accepted to participate in the study.
Tools for data collection:
Two tools were used to achieve the aim of this study included:
Tool I: Nurses’ Self-administered questionnaire: (Appendix I)
This tool was developed by the investigator after reviewing of related literatures. It was written in the Arabic language. It included three parts as follows:
Part I: it was concerned with demographic characteristics of the nurses under study and consisted of 6 open end questions that includes age, gender, Job description, educational level, years of experience, attendance of training courses about safety measures.
Part II: Nurses’ knowledge assessment questionnaire: it was developed by the investigator after reviewing related literatures (Blackburn & Walton, 2016; Loukas, Tubbs & Feldman, 2016; Ogle, 2021; Hanrahan et al., 2022) to assess nurses’ level of knowledge regarding arterial line safety measures in intensive care units .The total questionnaire consisted of 53 questions in the form of 13 multiple choice questions (MCQ) and 40 true &false questions distributed into five section as follows:
Section1: Nurses’ knowledge regarding arterial line and sites of arterial line placement (7 MCQ questions).
Section 2: Nurses’ knowledge regarding indications and contraindications of arterial line placement and Allen’ test (6 MCQ questions).
Section 3: Nurses’ knowledge regarding complications of arterial line placement (7 true /false questions).
Section 4: Nurses’ knowledge regarding removal of arterial line (5 true /false questions).
Section 5: Nurses’ knowledge regarding safety measures toward arterial line pre, during &post insertion (28 true/false questions).
Part III: Factors affecting nurses’ Compliance: it was developed by the investigator based on related literatures (Luo et al., 2010; Njovu, 2016; Suliman, 2018; AL-Gabri et al., 2020) to assess factors affecting nurses’ compliance regarding safety measures of arterial line. This part was divided into two sections including 39 questions as the follows:
Section 1: Human factors included Personal factors (10 items), Social factors (6 items) and psychological factors (6 items).
Section 2: Non-human factors included: Hospital factors (11 items), Availability of tools and capabilities necessary to implement safety measures for arterial line (6 items).
Tool II- Practice compliance–related safety measures observational checklist: (Appendix II):
This tool was developed by the investigator based on reviewing of related literature (Multak, 2015; Marino, 2019; British Association of Critical Care Nurses (BACCN), 2022). It was used to assess nurses’ compliance toward safety measures of arterial line and consist of (Nurses’ care compliance for arterial cannula and Nurses interpretation compliance for arterial cannula). It consisted of 179 steps distributed as follows:
• Care of arterial line observational checklist (22 steps)
- Changing the arterial line dressing observational checklist (33 steps)
- Assisting with insertion of the arterial catheter observational checklist (42 steps)
- Troubleshooting an Overdamped Waveform observational checklist (19 steps)
- Troubleshooting an Underdamped Waveform observational checklist (12 steps)
- Drawing arterial blood sampling via arterial line observational checklist (24 steps)
- Removal of arterial line observational checklist (27 steps).
Results
75.0% of the studied nurses age ranged between 18 <30 years old with Mean ±SD = 28.83 ± 7.459, 59 .2 % of them were females. Regarding to job description 56.6% of the studied nurses were staff nurses, whenever 42.1% of them have < 5 years of experience with Mean ±SD =8.105± 4.583 and 80.3% of them didn’t have training courses about safety measures in arterial line.
19.7 % of the studied nurses have a satisfactory total level of knowledge, while 80.3 % of them have unsatisfactory total level of knowledge regarding arterial line safety measures.
19.7 % of the studied nurses have competent total level of practices regarding nurses’ compliance to safety measures whenever, 80.3 of them have incompetent total level of practices.
76.3% of studied nurses reported that total factors affect nurses’ compliance to safety measure in arterial catheter whenever, 23.7% of studied nurses reported that, total hospital factors not affect their compliance to safety measure in arterial catheter.
There was a statistically significant correlation between studied nurses’ total knowledge about safety measures in arterial line and their total compliance and factors affecting their compliance at p. value <0.001.
Conclusion
In the light of the current study findings, it can be concluded that:
A majority of the study nurses had unsatisfactory level of knowledge & incompetent level of practice in following arterial line safety measures. Additionally, a substantial number of the study nurses recognize that certain factors impact their ability to comply with safety measures of arterial line. And there was a significant correlation between studied nurses ’ total level of knowledge and compliance and factors affecting their compliance regarding safety measures of arterial line.
Recommendations
Based on the current study finding the following recommendations were proposed:
Implementing an educational training program for nurses to improve their compliance regarding arterial line safety measures.