Document Type

Article

Publication Date

Summer 7-12-2026

Abstract

Abstract: Background: Healthcare-associated infections (HAIs) remain a major global patient safety challenge, contributing substantially to morbidity, mortality, prolonged hospitalization, antimicrobial resistance, and increased healthcare costs. Patients admitted to cardiac intensive care units (ICUs) are particularly vulnerable because of their critical illness, frequent exposure to invasive devices, and complex cardiovascular interventions. Nurses play a pivotal role in preventing HAIs through the consistent implementation of evidence-based infection prevention and control (IPC) measures. Therefore, assessing both nurses' knowledge and their observed clinical practices is essential for identifying strengths, potential gaps, and opportunities for quality improvement. Aim: To assess nurses' knowledge and observed practices regarding infection prevention measures in a cardiac intensive care unit and to examine the relationship between knowledge level and practice competency. Methods: A descriptive cross-sectional study was conducted using a census sampling approach involving all eligible registered nurses (N = 46) permanently employed in the Adult Cardiac Intensive Care Unit at Aswan Heart Center, Egypt. Data were collected using a structured self-administered knowledge questionnaire developed in accordance with World Health Organization (WHO) and Centers for Disease Control and Prevention (CDC) infection prevention recommendations, together with a standardized observational checklist adapted from the CDC Infection Control Assessment and Response (ICAR) Tool. Each nurse was observed during three separate clinical shifts to enhance the reliability of practice assessment. Data were analyzed using IBM SPSS Statistics version 21. Descriptive statistics summarized participants' characteristics, knowledge, and practice levels, while Pearson's Chi-square test examined the association between knowledge level and practice competency. Statistical significance was established at p < 0.05. Results: Thirty nurses (65.2%) demonstrated good knowledge, whereas sixteen (34.8%) demonstrated fair knowledge; none exhibited poor knowledge. Overall, observed infection prevention practices were competent across all assessed domains, with compliance meeting or exceeding the predefined competency threshold. High adherence was observed for ventilator care, medication preparation, airborne isolation precautions, sharps disposal, and personal protective equipment use, whereas comparatively lower compliance was identified in hand hygiene and urinary catheter care. No statistically significant association was found between nurses' knowledge level and observed practice competency (χ² = 0.013, p = 0.910). Conclusion: Nurses working in the cardiac intensive care unit demonstrated satisfactory theoretical knowledge and competent implementation of evidence-based infection prevention measures. However, theoretical knowledge alone did not predict observed clinical performance, indicating that organizational support, standardized clinical protocols, continuous competency assessment, and institutional safety culture may exert greater influence on adherence than knowledge alone. Sustaining high-quality infection prevention practices therefore requires multifaceted strategies integrating continuous professional education, routine observational auditing, performance feedback, and strong organizational commitment to patient safety.

Comments

This article examines nurses' knowledge and observed clinical practices regarding infection prevention measures in a cardiac intensive care unit. The findings highlight satisfactory knowledge and competent infection prevention practices while emphasizing the importance of continuous competency assessment, organizational support, and quality improvement initiatives to strengthen patient safety and reduce healthcare-associated infections.

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