Document Type

DNP - Open Access

Award Date

2024

Degree Name

Doctor of Nursing Practice (DNP)

Department

Graduate Nursing

First Advisor

Dannica Callies

Second Advisor

Theresa Garren-Grubbs

Abstract

Background: Central line associated bloodstream infections (CLABSIs) are preventable healthcare associated infections (HAI) in the United States. CLABSIs are associated with increased length of hospital stays, mortality, and financial implications for both patients and hospital systems. Extensive research has shown implementing CLABSI prevention bundles can reduce infections and costs. These bundles are often misused, highlighting the importance of bundle compliance and education.
Local Problem: A medical surgical unit in the upper Midwest continues to have delayed central line removal despite a CLABSI prevention bundle. Efforts to decrease central line days were identified as a priority.
Methods: Staff completed education on CLABSI prevention and one portion of the CLABSI bundle, central line necessity. Nursing staff performed a daily assessment of central line necessity and collaborated with providers on central line removal. The central line days during the 3 months leading up to implementation were compared with the central line days in the 3 months following implementation.
Intervention: An electronic healthcare record SmartPhrase was created to prompt nurses to document their daily assessment of central lines. The SmartPhrase included questions about central line necessity. If central line necessity was not met, the provider was contacted to order device removal.
Results: While there was an overall decrease in central line days, the absence of statistical significance prevents drawing definitive conclusions from the intervention.

Library of Congress Subject Headings

Nosocomial infections -- Prevention.
Intravenous catheterization -- Complications -- Prevention.
Medical protocols.

Publisher

South Dakota State University

Rights

Copyright 2024 Katherine Wickstrom

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