Color-Coded Labels Cued Nurses to Adhere to Central Line Connector Change

Area of Science:

• Healthcare quality improvement
• Infection prevention
• Nursing practice

Background:

• Central line-associated bloodstream infections (CLABSIs) are a significant concern in healthcare settings.
• Adherence to policies for changing needleless connectors is crucial for preventing CLABSIs.
• Current methods for tracking connector changes, such as electronic medical record (EMR) documentation, may have limitations.

Purpose of the Study:

• To evaluate the effectiveness of a novel day-of-the-week, color-coded label system in improving nurses' adherence to needleless connector change policies.
• To compare the impact of the color-coded label intervention with usual care relying on EMR documentation.

Main Methods:

• A prospective, comparative study was conducted across four medical-surgical units in a large healthcare system.
• Nurses' adherence was assessed by observing bedside label use and EMR documentation of needleless connector changes at 4-day intervals.
• Intervention units utilized day-of-the-week, color-coded labels on needleless connectors, while control units followed standard EMR documentation procedures.
• Multinomial logistic regression models were employed to analyze the data, accounting for clustering within units.

Main Results:

• Units using color-coded labels demonstrated a 321% increase in the rate of needleless connector change documentation in the EMR compared to control units (OR, 4.21; 95% CI, 1.76-10.10; P = .003).
• The presence of labels on needleless connectors significantly increased the likelihood of nurses documenting connector changes according to policy (OR, 4.72; 95% CI, 2.02-10.98; P = .003).

Conclusions:

• Day-of-the-week, color-coded labels effectively prompted nurses to document needleless connector changes in the EMR, thereby enhancing adherence to policy.
• This labeling system represents a practical strategy to improve timely needleless connector changes, which may contribute to a reduction in CLABSI rates.