Reducing Central Line-Associated Bloodstream Infections in the ICU: A Nurse-Led Evidence Based Quality Improvement...

Area of Science:

• Quality Improvement
• Infection Prevention
• Nursing Practice

Background:

• Central line-associated bloodstream infections (CLABSI) are a significant concern in intensive care units (ICUs).
• Effective central venous catheter (CVC) maintenance is crucial for preventing these infections.
• Bridging the gap between evidence-based guidelines and clinical practice is essential for improving patient outcomes.

Purpose of the Study:

• To develop, implement, and evaluate a nurse-led, evidence-based CVC maintenance flowchart.
• To reduce CLABSI rates in five adult ICUs.
• To enhance adherence to best practices in CVC care.

Main Methods:

• A prospective, pre-post intervention quality improvement project.
• Systematic literature review and evidence grading (Joanna Briggs Institute).
• Development and implementation of an evidence-based CVC Maintenance Flowchart across five ICUs.

Main Results:

• CLABSI rates decreased significantly from 4.55 to 1.68 per 1000 CVC-days (63.2% reduction).
• Nurse adherence to CVC maintenance practices increased from 78% to 94.4%.
• Central line utilization ratio remained stable, confirming improved care quality.

Conclusions:

• Nurse-led quality improvement initiatives can substantially reduce CLABSI rates.
• Empowering nurses with structured implementation frameworks improves evidence-based practice.
• This model can enhance patient safety and other nurse-sensitive outcomes in ICUs.