Date of Award

4-2-2018

Degree Name

Nursing (D.N.P.)

Department

College of Nursing

First Advisor

Dr. Sandra Spoelstra

Second Advisor

Dr. Marie Vanderkooi

Third Advisor

Katherine Celentino

Abstract

Central Line-Associated Bloodstream Infection (CLABSI) is a preventable issue in healthcare. CLABSI contributes to negative patient outcomes and increased healthcare cost. Research demonstrates that many interventions are effective in reducing the rate of CLABSI. The implementation of CLABSI bundles can significantly reduce the occurrence of CLABSI. This quality improvement project implemented a CLABSI bundle that specifically targeted identified areas of weakness in CLABSI prevention at an organization with a focus on adult oncology care. The three part CLABSI prevention bundle focused on: (a) registered nurses (RN) changing and documenting endcaps in the electronic health record after blood administration, (b) RNs asking about the necessity of central lines during daily rounds and encouraging the removal of unnecessary central lines with the interdisciplinary team, including the physician, and (c) RNs and nurse technicians (NTs) prioritizing and providing chlorhexidine (CHG) baths to patients with central venous catheters daily. Two conceptual models were used to provide a framework for implementation. A pre-post quiz was provided to staff members before and after CLABSI education. Implementation took place over one month. Results yielded a 19.2% (76.6% [n=32] to 95.8% [n=30], p-Value=0.0015) increase in CLABSI prevention knowledge after education, 89.0% (0% [n=7] to 88.9% [n=18], p-Value <0.0001) endcap change rate, 91.2% (0% [n=8] to 91.2% [n=102], p-Value <0.0001) rate for assessing central line necessity during rounds, and CHG bathing at 83.8% (81.2% [n=445] to 83.8% [n=115], p-Value>0.05). No CLABSI were noted during the implementation phase.

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