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Adherence to the central line bundle in intensive care: An integrative review

Cherie Burke1, Karen Jakub1, Ian Kellar2

  • 1Duquesne University School of Nursing, Pittsburgh, PA.

American Journal of Infection Control
|November 22, 2020
PubMed

Insights

Adherence to central line bundle guidelines for preventing central line-associated bloodstream infections (CLABSI) is inconsistent. Further research and innovative technology are needed to achieve full compliance and reduce infection rates in intensive care units.

Area of Science:

  • Infection Control
  • Healthcare Quality Improvement
  • Patient Safety

Background:

  • Central line-associated bloodstream infections (CLABSI) in intensive care units (ICUs) significantly increase patient morbidity, mortality, hospitalization duration, and healthcare costs.
  • The Centers for Disease Control and Prevention (CDC) developed evidence-based guidelines and a checklist bundle to prevent CLABSIs.
  • Despite established protocols, there is considerable variation in compliance with central line bundle policies and resulting infection rates within ICUs.

Purpose of the Study:

  • To systematically review and synthesize existing research on adherence to the central line bundle recommendations for CLABSI prevention.

Main Methods:

  • An integrative literature review was conducted.
  • Searches were performed across CINAHL, PubMed, and SCOPUS databases.
  • Whittemore and Knafl's integrative review methodology was employed.

Main Results:

  • From 608 initial articles, 407 were screened, and 19 were included in the final review.
  • Crucially, none of the 19 studies reported adherence to all 14 recommendations within the central line bundle checklist.
  • Significant gaps in adherence to the central line bundle were identified across the reviewed literature.

Conclusions:

  • The review highlights substantial gaps in adherence to the central line bundle for CLABSI prevention.
  • Further research is essential to accurately assess adherence to individual bundle components and identify factors contributing to noncompliance.
  • Innovative technological solutions may be required to achieve comprehensive compliance with all central line bundle elements.
Abstract

Keywords:
Central line associated bloodstream infectionCentral line associated bloodstream infection bundleCentral line related infectionGuideline adherenceIntensive care unitPractice guideline

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