Abstract:

Objective To develop and preliminarily apply a risk assessment tool for central line associated bloodstream infections（CLABSI） associated with needle-free connectors. Methods The draft tool was developed through literature review，Delphi expert consultation，Analytic Hierarchy Process（AHP），and ABC classification. A convenience sample of 200 inpatients with central venous catheters connected to needle-free connectors was selected from a tertiary hospital in Changzhou，between October and November 2025. Risk factors pertaining to the needle-free connectors were assessed to examine the tool’s reliability and validity. A self-controlled before-after design was adopted，in which a knowledge，attitude，and practice（KAP） questionnaire survey on the disinfection of needle-free connectors after intermittent medication administration was conducted among 48 nurses who used the tool，to evaluate its application effect. Results The final tool comprises 4 dimensions（medication characteristics，connector status，patient and catheter factors，clinical practice environment） and 11 items. The overall Cronbach’s α coefficient was 0.831，and the content validity index was 0.930. Inter-dimension correlations ranged from 0.440 to 0.557（all P<0.05）. Confirmatory factor analysis indicated acceptable model fit indices. After using the tool，nurses’ scores significantly increased in knowledge 25.00（20.00，25.00），attitude 16.00（16.00，18.00），practice 24.00（22.00，24.00） dimensions and total score 63.00（60.00，65.00） compared to preintervention levels（all P<0.001）. Conclusion The risk assessment tool for needle-free connector associated CLABSI developed in this study demonstrated good reliability and validity. It can enhance nurses’ risk awareness，positive attitudes，and operational compliance in key procedures such as post-intermittent medication disinfection.

Key words: Needle-Free Connector, Central Line Associated Bloodstream Infections, Risk Assessment, Reliability, Validity, Nursing Care

摘要：

目的 构建与无针输液接头相关的导管相关性血流感染风险评估工具并进行初步应用。方法 通过文献分析、德尔菲专家函询、层次分析、主次因分析法和预调查形成评估工具初稿，便利选取2025年10—11月常州市某三级甲等综合医院使用中心静脉导管且导管末端连接无针输液接头的200例住院患者，对其使用的无针输液接头进行风险因素评估，检验工具的信效度。采用自身前后对照设计，对48名使用该工具的护士进行无针输液接头间歇性给药后消毒知信行问卷调查，评价其应用效果。结果 该风险评估工具包含药物特性、接头情况、患者与导管置管因素、临床实践环境因素4个维度、共11个条目，总的Cronbach’s α系数为0.831，内容效度指数为0.930，各维度相关性为0.440~0.557（均P<0.05）。验证性因子分析显示，模型适配度各检验量均在可接受范围内。护士应用该工具后，相关知识、态度、行为各维度得分及总分分别为25.00（20.00，25.00）、16.00（16.00，18.00）、24.00（22.00，24.00）、63.00（60.00，65.00）分，高于应用前（均P<0.001）。结论 构建的与无针输液接头相关的导管相关性血流感染风险评估工具信效度良好，能强化护士在间歇性给药后消毒等关键操作环节的风险意识、积极态度，并促进操作规范性。

关键词: 无针输液接头, 导管相关性血流感染, 风险评估, 信度, 效度, 护理