A team of clinicians at the University of Pittsburgh have developed a quality improvement initiative to identify barriers to adherence to a central line care bundle, for maintenance purposes.
Description
Central lines, often called central venous catheters (CVC), are intravenous lines used to directly access the large vein near the heart, or the heart itself. Often used for delivering chemotherapy or other medications to patients, CVC can be lifesaving; however, they are also a source of infection, leading to central-line associated bloodstream infection (CLABSI). CLABSIs impact roughly a quarter of a million patients globally each year. This novel survey is designed to understand challenges with maintenance and management of CVC, to aid removal of barriers and potentially save lives through reducing the risk of infection in already vulnerable patients.
Applications
• Infection control protocols
• ICU
• Oncology
Advantages
Currently a set of straightforward guidelines endorsed by The Institute for Healthcare Improvement, referred to as a bundle, is the current best practice approach to managing CVC patients and improving outcomes. However, adherence to the bundle is not 100% with CLABSI still a major problem in some institutions.
This survey involves 26 questions and is designed to identify barriers to adherence to the bundle. These barriers can include issues around training and support for staff, labeling of dressings, or ease of use of equipment. Better understanding allows for institutions/medical units to develop initiatives to tackle these barriers and improve care.
Invention Readiness
A recent study used this survey in ICU and oncology targeted units to identify areas of non-adherence to the bundle for CVC care. Identified barriers included insufficient supplies in the central line dressing kit, a lack of hands-on experience, and a knowledge gap in the evidence base of bundles. Unit specific interventions such as improvements to kit contents, increased support from senior staff, and education of key elements of the bundle improved adherence with a reduction in CLABSI within the targeted units.
IP Status
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