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Reducing Central Line Utilization by Peripherally Infusing Vasopressors.

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    Summary
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    A new nurse-driven protocol significantly reduced central line use for vasopressor infusions in the MICU by 37.9%. This quality improvement initiative also boosted nurse confidence and prevented bloodstream infections, demonstrating effective protocol implementation.

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    Area of Science:

    • Critical Care Medicine
    • Infection Prevention
    • Nursing Quality Improvement

    Background:

    • Central line-associated bloodstream infections (CLABSIs) are a significant cause of mortality and healthcare costs.
    • Vasopressor infusions frequently necessitate central line placement.
    • A lack of standardized practice for vasopressor infusion routes existed in the medical intensive care unit (MICU).

    Purpose of the Study:

    • To implement an evidence-based, nurse-driven protocol for peripheral vasopressor infusion.
    • To decrease central line utilization by a target of 10%.

    Main Methods:

    • Protocol education was delivered to MICU nurses, residents, and crisis nurses.
    • A 16-week implementation period followed the education phase.
    • Nursing staff surveys were conducted pre- and post-protocol implementation.

    Main Results:

    • Central line utilization decreased by 37.9%.
    • Zero CLABSIs were recorded during the study period.
    • Most nurses reported increased confidence in peripheral vasopressor administration without a central line; no significant extravasation events occurred.

    Conclusions:

    • A nurse-driven protocol for peripheral vasopressor infusion is effectively implementable in practice.
    • The observed reduction in central line use is clinically significant, mitigating risks associated with central lines.
    • Enhanced nursing confidence supports the continued adoption of this protocol.