Implementation of central line bundles: experience and challenges

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Intravenous literature: McPeake, J., Cantwell, S., Malcolm, B. and Malcolm, D. (2012) Central line insertion bundle: experiences and challenges in an adult ICU. Nursing in Critical Care. 1 March [epub ahead of print].

Abstract:

Background: Central venous catheters are used frequently in the intensive care unit (ICU). However, there is an associated morbidity, mortality and cost derived from their infectious and mechanical complications. The Scottish Patient Safety Programme (SPSP) has developed a multi faceted care bundle, with the aim of reducing catheter-related blood stream infections.

Aim: This paper aims to identify and describe the experience and challenges in implementing the SPSP central line insertion bundle in one adult ICU, in a large inner city teaching hospital.

Interventions: ˜Plan-Do-Study-Act’ cycles, checklists for insertion and a standardized trolley were adopted to implement the central line insertion bundle in clinical practice.

Conclusion/Implications: Improving the reliability of the central line insertion bundle has reduced infections. Key steps in the process were setting clear aims and ensuring staff understand the change process and measurement of results. This is fundamental to the success of any quality improvement process.

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