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Central line-associated bloodstream infections (CLABSI) are a serious health issue evidenced in the hospital intensive care units (ICUs) that brings a significant burden on the medical and financial aspects. A quality initiative in our facility involved the use of checklists for placing central venous lines (CVL) for reducing and preventing CLABSIs in ICU settings. The approaches used for CVL placement involved: full barrier nursing, hand disinfection, avoiding femoral vein, sterile disinfection of the site of insertion, and strict indication for CVL. The handling of CVL placements is done by experienced ICU staff, physicians, and nurses who were given intensive training on hygienic procedures. In addition, periodic reminders were given during staff meetings to enhance awareness. The checklists included the bundle components, identifying the setting (catheter site, type, and urgency of placement), and documentation of the duration of the procedure and members involved. The introduction of the checklist significantly improved the compliance levels with hygiene standards ensured for CVL placements as well as contributed to a remarkable decrease in CLABSI rates. Checklists are a valuable tool used for preventing CLABSIs in ICUs and contribute remarkably towards improving patient safety and reduction of costs. Hence, the use of checklists facilitated in improving the quality of standard tasks related to the high proportion of complications (Wichmann et al., 2018).
The barriers to implementation of checklists were lack of compliance, type of tool utilized (Electronic vs Paper), absence of specialized software, lack of 100% internet availability, and increased demand for comprehensive checklist content. The translation of research findings into clinical practice is pivotal towards improving efficient and effective patient care as well as improving nursing care quality. However, translation of these EBP findings is impacted due to the following barriers: lack of sufficient time, lack of adequate resources, insufficient facilities for implementing ideas, lack of authority to steer change, and lack of interest in adopting change (Cebohin et al., 2021).
References-:
Cebohin, M., Pavlovic, D., Smolic, R., Hnatesen, D., Farcic, N., & Marjanovic, K. (2021). Croatian registered nurses – perception of barriers to research utilization: A cross-sectional study. Open Access Macedonian Journal of Medical Sciences, 9(G), 28-33. https://doi.org/10.3889/oamjms.2021.6013
Wichmann, D., Campos, C. E., Ehrhardt, S., Kock, T., Weber, C., Rohde, H., & Kluge, S. (2018). Efficacy of introducing a checklist to reduce central venous line-associated bloodstream infections in the ICU caring for adult patients. BMC Infectious Diseases, 18(1), 267. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5994052/
