Formative Evaluation of CLABSI Adoption and Sustainment Interventions in a Pediatric Intensive Care Unit.

Lindsey J Patton, Angelica Morris, Amanda Nash, Kendel Richards, Leslie Huntington, Lori Batchelor, Jenna Harris, Virginia Young, Carol J Howe
Author Information
  1. Lindsey J Patton: From the Children's Critical Care Services and Nursing Research, Dallas, Tex.
  2. Angelica Morris: From the Children's Critical Care Services and Nursing Research, Dallas, Tex.
  3. Amanda Nash: From the Children's Critical Care Services and Nursing Research, Dallas, Tex.
  4. Kendel Richards: From the Children's Critical Care Services and Nursing Research, Dallas, Tex.
  5. Leslie Huntington: From the Children's Critical Care Services and Nursing Research, Dallas, Tex.
  6. Lori Batchelor: From the Children's Critical Care Services and Nursing Research, Dallas, Tex.
  7. Jenna Harris: From the Children's Critical Care Services and Nursing Research, Dallas, Tex.
  8. Virginia Young: From the Children's Critical Care Services and Nursing Research, Dallas, Tex.
  9. Carol J Howe: Harris College of Nursing, Texas Christian University, Fort Worth, Tex..

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 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.

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Word Cloud

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