Investigation of Nursing Compliance with Sterile Needleless Access Device Changes: A Quality Improvement Project
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Authors
Murphy, Kaylin
Issue Date
2018-05-12
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Abstract
Pediatric patients with central lines are at a higher risk for Central Line-Associated Blood Stream Infections (CLABSIs), which increases their risk for other consequences such as longer hospital stays, risk for prolonged or worsening illness, increased cost of healthcare, and increased risk for mortality. A Midwestern Children's Hospital's Pediatric Intensive Care Unit (PICU) has taken recommendations from the Solutions of Patient Safety (SPS), a National Pediatric Collaborative, to decrease the number of CLABSIs to zero. The PICU has implemented a "bundle" that consists of protocols and guidelines on the insertion, management, and removal of central lines. One of the main barriers to a successful implementation of a new protocol includes compliance. This quality improvement project addressed nursing education on the new protocol of a standardized work process for sterile Needleless Access Device (NAD) changes. The goal of the QI project was to determine current protocol knowledge and compliance concerning central line maintenance through bedside nursing surveys and audits, identify barriers to compliance and determine the impact of reinforced education on nursing knowledge and compliance through post-education audits. Key findings of this project suggest that reinforced education has a positive impact on nursing compliance, follow-up or re-education is needed when a new protocol is implemented, and nurses value reinforcement and a hands on approach when a new protocol including a hands on skill is implemented.
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Creighton University
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Copyright is retained by the Author. A non-exclusive distribution right is granted to Creighton University