Abstract
Purpose: The purpose of this quality improvement project was to identify current central venous catheter (CVC) maintenance practices of registered nurses (RNs), provide education based on survey results, and perform a follow up survey to assess improvement in nurses' adherence to policy.|Background: A CVC is a central venous catheter that terminates at or close to the heart or in one of the great vessels. Bacteria, fungi or viruses can enter the bloodstream via the CVC and can lead to a serious systemic illness. A CLABSI is defined as a laboratory-confirmed bloodstream infection where a CVC was in place for more than two calendar days. CLABSIs are one of the top five most common hospital acquired infections, resulting in increased length of hospital stay, increased patient mortality, and increased healthcare costs. CLABSIs are preventable infections and through focused interventions and proper management of the CVC, infection rates can be reduced. The implementation and adherence to evidence-based practice guidelines in the maintenance of CVCs by RNs can help to decrease infection rates. Reducing the CLABSIs will result in improving patient outcomes by lessening healthcare costs, decreasing length of stay, and reducing mortality rates.|Sample/Setting: The setting for this project was located at a large academic hospital in the. The sample included all RNs who were employed on a 36 bed medical-surgical unit. 47 RNS were asked to voluntarily complete the initial survey, only 40 RNs were available to voluntarily complete the follow up survey.|Methods: A descriptive design study used to identify current CVC maintenance practices from RNs and to educate nurses based on needs according to a voluntary survey. Nurses were surveyed on current CVC practices, education was provided based on identified deviations from policy recommendations, and re-surveyed to assess improvement of CVC practices.|Results: Respondent rates of surveys prior to education implementation ranged from 63.83% to 68.09%. The majority of respondents endorsed "always" completing CVC practices on all surveys. Initial respondents reported "always" 29.03% to 90.32% of the time. Post education respondents rate percentages was 67.5%. After education was completed respondents endorsed "always" ranging from 40.74% to 96.30% of the time.|Conclusions: Post education respondents selected "always" at a higher percentage rate than the pre-education surveys. The endorsement change improved in eight of the twelve questions. There was limited generalizability with no randomization and low response rate with no control group. Thus concluding that there was not enough evidence to suggest that the education had any effect on the survey response rate. There was also not enough evidence to conclude that the intervention does not work.