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Updated: Sep 14, 2025
09:57
A Protocol to Set Up Needle-Free Connector with Positive Displacement on Central Venous Catheter in Intensive Care Unit
Published on: July 13, 2019
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Implementation Frameworks, Strategies, and Outcomes in Optimizing Central Venous Access Device Practice in Neonates:
Elouise R Comber1,2, Deanne August1,2,3, Linda N Nguyen1,2
1The University of Queensland, Brisbane, Australia.
Hospital Pediatrics
|July 21, 2025
Summary
This review found that neonatal central venous access device (CVAD) practices often use quality improvement initiatives and focus on health professional education. Broader, outcome-focused implementation research for neonatal CVADs is lacking.
Area of Science:
- Neonatal intensive care
- Clinical practice implementation
- Healthcare quality improvement
Background:
- Central venous access devices (CVADs) are vital in neonatal care.
- Inconsistent practices with CVADs present a significant challenge, impacting patient outcomes.
- Existing research lacks a comprehensive overview of implementation frameworks for neonatal CVADs.
Purpose of the Study:
- To conduct a scoping review of implementation frameworks, strategies, and outcomes for central venous access devices in neonates.
- To identify current trends and gaps in the implementation research of neonatal CVAD practices.
Main Methods:
- A systematic search of major databases (EMBASE, CINAHL, PubMed, Web of Science, Cochrane Library) was performed.
- Studies published between 2012 and August 2024 in English were included.
- Study eligibility and quality were assessed by independent reviewers using the Mixed Methods Appraisal Tool.
Main Results:
- 44 studies were included, primarily from intensive care units and single-site settings.
- "Quality improvement" was the most common implementation framework (61%).
- Health professional education (80%), audits/surveillance (77%), and bundles (66%) were frequent strategies; infection was the most reported outcome (84%).
Conclusions:
- Current implementation frameworks for neonatal CVADs are predominantly unstructured quality improvement efforts.
- There is a limited focus on a narrow range of strategies targeting healthcare professionals.
- A need exists for broader, outcome-driven implementation research in neonatal CVAD practice.
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