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Adherence to the central line bundles in intensive care

"Despite the promotion of central line bundle policies, wide variability exists in compliance and infection rates in intensive care units" Burke et al (2020).

Abstract:

Background: Central line-associated bloodstream infections (CLABSI) occurring in intensive care units are associated with increased morbidity and mortality, increased length of hospitalization, and cost of care associated with treating central line-associated bloodstream infections. The Centers for Disease Control and Prevention (CDC) guidelines and checklist bundle are intended to provide evidence-based recommendations for the prevention of central line-associated bloodstream infections. Despite the promotion of central line bundle policies, wide variability exists in compliance and infection rates in intensive care units.

Objective: To evaluate and synthesize the existing literature on adherence to the central line bundle recommendations for the prevention of CLABSI.

Design: Integrative literature review DATA SOURCES: CINHAL, PubMed, and SCOPUS databases were searched.

Review methods: Whittmore and Knafl’s integrative review method RESULTS: A total of 608 articles were identified, 407 articles were screened for topic of interest and adherence to the inclusion criteria, and 19 articles were included in this review. None of the 19 studies addressed adherence to all 14 recommendations of the central line bundle checklist.

Conclusion: This integrative review identified gaps in adherence to the central line bundle. Research is needed to determine the actual adherence to each item in the bundle, and to investigate factors that contribute to non-adherence. To achieve complete compliance with all the bundle items creative and innovative technology is needed.

Reference:

Burke C, Jakub K, Kellar I. Adherence to the central line bundle in intensive care: An integrative review. Am J Infect Control. 2020 Nov 19:S0196-6553(20)30998-6. doi: 10.1016/j.ajic.2020.11.014. Epub ahead of print. PMID: 33221472.