Table 1 Specific expectations for intensivists using US guidance, practices evaluated and results obtained
Evaluated criteria | Obtained results according to study method | ||
|---|---|---|---|
Questionnaires (n = 111) | Observations (n = 36) | ||
General recommendations | |||
The use of USG for the insertion of central venous catheter is recommended | HCWs using USG (systematically or frequently) for central venous catheter compared to the total N HCWs | 98 (88.3%) | – |
Training of HCWs in the use of USG is recommended | HCWs trained compared to N HCWs using USG | 59 (56.2%) | 16 (44.4%) |
A procedure is available to HCWs who insert catheters using USG | HCWs having a procedure compared to N HCWs using USG | 18 (17.1%) | – |
Insertion site marking | |||
It is recommended to mark the insertion site using USG before skin antisepsis | HCWs carrying out marking before skin antisepsis (systematically or often) compared to N HCWs using USG | 72 (75.6%) | 21 (58.3) |
A compliant hand rubbing is recommended before starting | HCWs carrying out compliant hand rubbing compared to N HCWs carrying out marking | – | 10 (47.6%) |
It is not recommended to cover the probe by a sterile sheath | HCWs not using a sheath compared to N HCWs carrying out marking | 71 (72.4%) | 15 (71.4%) |
It is not recommended to use sterile gel | HCWs not using sterile gel compared to N HCWs carrying out marking | 69 (70.4%) | 16 (76.2%) |
Skin antisepsis | |||
A compliant hand rubbing is recommended before starting | HCWs carrying out compliant hand rubbing compared to N HCWs carrying out antisepsis | – | 17 (63.0%) |
It is not recommended to glove | HCWs not gloving compared to N HCWs carrying out antisepsis | – | 0 |
In case of gloving, it is recommended to remove gloves at the end of skin preparation | HCWs removing their gloves at the end of skin antisepsis compared to N HCWs gloving during this phase | – | 15 (55.6%) |
Insertion of the catheter | |||
A surgical hand disinfection followed by sterile gloving is recommended prior starting | HCWs carrying out compliant surgical hand disinfection and sterile gloving compared to the total N HCWs | – | 12 (33.3%) |
It is recommended to cover the probe and the connection cable of the US system with a sterile sheath when inserting the catheter | |||
HCWs covering probe with a sterile sheath compared to the total N HCWs | 105 (100.0%) | 36 (100.0%) | |
HCWs covering probe and cable with a sterile sheath compared to the total N HCWs | – | 32 (88.9%) | |
It is recommended to use single-dose sterile gel applied inside and outside the sheath when inserting the catheter | |||
HCWs using single-dose sterile gel compared to the total N HCWs | 101 (96.2%) | 36 (100.0%) | |
HCWs applying the gel inside and outside the sheath compared to the total N HCWs | 19 (18.1%) | 5 (13.9%) | |
The tip of the needle must never come into contact with the sheath of the probe | Insertions with contact between the needle and the sheath related to the total N insertions | – | 7 (19.4%) |
The HCW must immediately change his gloves after handling the US system during catheter insertion | US system handling without glove changing related to the total N insertions | – | 1 (2.8%) |