Abstract:
Background: Pediatric patients require central venous catheters to maintain adequate hydration, nutritional status, and delivery of life-saving medications in the pediatric intensive care unit. Although central venous catheters provide critical medical therapies, their use increases the risk of severe infection, morbidity, and mortality. Adopting an evidence-based central line-associated bloodstream infection (CLABSI) bundle to guide nursing practice can decrease and sustain low CLABSI rates, but reliable and consistent implementation is challenging. This study aimed to conduct a mixed-methods formative evaluation to explore CLABSI bundle implementation strategies in a PICU.
Methods: The team used The Consolidated Framework for Implementation Research to develop the interview guide and data analysis plan.
Results: Facilitators and barriers for the CLABSI bundle occurred in four domains: inner setting, process, characteristics of individuals, and innovation characteristics in each cycle that led to recommended implementation strategy opportunities. The champion role was a major implementation strategy that facilitated the adoption and sustainment of the CLABSI bundle.
Conclusions: Implementation Science Frameworks, such as Consolidated Framework for Implementation Research (CFIR), can be a beneficial framework to guide quality improvement efforts for evidence-based practices such as the CLABSI bundle. Using a champion role in the critical care setting may be an important implementation strategy for CLABSI bundle adoption and sustainment efforts.
Reference:Patton LJ, Morris A, Nash A, Richards K, Huntington L, Batchelor L, Harris J, Young V, Howe CJ. Formative Evaluation of CLABSI Adoption and Sustainment Interventions in a Pediatric Intensive Care Unit. Pediatr Qual Saf. 2024 Apr 3;9(2):e719. doi: 10.1097/pq9.0000000000000719. PMID: 38576891; PMCID: PMC10990306.