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NURS 5052 Week 10 Central Line Insertion Bundles and CLABSI Prevention: A Literature Review


Evidence-based practice plays a vital role in making patient care decisions by combining the best evidence, patient preferences, and clinical judgment. In the healthcare field, continuous research is essential to keep up with evolving practices. This paper focuses on the effectiveness of current guidelines for central venous catheter (CVC) insertion and maintenance in preventing Central Line-Associated Bloodstream Infections (CLABSI). While existing protocols have shown a reduction in CLABSI rates, the primary challenge lies in ensuring proper adherence to these protocols by healthcare professionals. This paper emphasizes the importance of education and resources dedicated to educating healthcare workers on the correct procedures for CVC insertion and maintenance.

Identifying the Research Problem

CLABSI is a significant concern in healthcare, leading to longer hospital stays, increased mortality rates, and higher costs. Maintenance bundles for CVC insertion and maintenance have been adopted by many healthcare facilities to mitigate CLABSI risks. CLABSI impacts nursing practice by prolonging patient stays and increasing the workload on nurses, potentially leading to burnout. This paper aims to address the problem of insufficient adherence to guidelines among nurses and physicians responsible for inserting and maintaining central lines.

NURS 5052 Week 10 Central Line Insertion Bundles and CLABSI Prevention: A Literature Review Research Questions and Feasibility

To ensure proper adherence to central line insertion bundles, monitoring procedures are necessary. This includes tracking proper skin cleaning, maintaining maximal sterile barrier precautions, and selecting suitable veins during insertion. The feasibility of monitoring adherence requires assessing the skin preparation process, evaluating infection rates among patients receiving daily chlorhexidine gluconate (CHG) baths compared to those who do not, examining the cost-effectiveness of alcohol-impregnated caps on unused ports, determining the optimal frequency for central line dressing changes, and comparing central catheter maintenance bundles across different healthcare facilities in the area.

NURS 5052 Week 10 Central Line Insertion Bundles and CLABSI Prevention: A Literature Review PICOT Question

Population: Patients receiving a central line

Intervention: Central catheter insertion and maintenance bundle

Comparison: Central lines inserted without using a central catheter insertion and maintenance bundle

Outcome: CLABSI rate of patients with a Central Catheter inserted using a CVC insertion and maintenance bundle

Time: No specified time frame

Keywords for Literature Search

CLABSI, CLABSI prevention, Central Venous Catheter insertion bundle, Central Venous Catheter, CHG baths, Central Venous Catheter Infections

NURS 5052 Week 10 Central Line Insertion Bundles and CLABSI Prevention: A Literature Review

A systematic review and meta-analysis show that central line insertion and maintenance bundles effectively reduce CLABSI rates in all age ICU patients (Ista et al., 2016). Another meta-analysis and systematic review highlight the impact of quality improvement interventions on CLABSI rates, emphasizing the need for adequate resources, knowledge, and guideline compliance (Blot et al., 2014). A systematic review comparing a surgical intensive care unit implementing a central line bundle to a cardiac care unit without implementation demonstrates a 68% decrease in CLABSI rate in the former (university study) (Author et al., 20XX). A survey on nurse PICC teams indicates that specialized teams lead to higher adherence to central line insertion and maintenance bundles, resulting in reduced CLABSI rates (random sample survey) (Author et al., 20XX). An observational study reveals that compliance with CLABSI prevention guidelines is higher among nurses with a 1:1 nurse-patient ratio, suggesting potential improvements in patient outcomes through reduced nurse-patient ratios (Aloush & Alsaraireh, 2018).

Summary of Literature Review

The reviewed articles consistently support the implementation of central line insertion and maintenance bundles to decrease CLABSI rates. Interventions discussed include bundles, education on CLABSI prevention, and effective education of medical staff for guideline adherence. Adherence to guidelines is identified as a significant challenge,.

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