2025 Article # 3
Central Line Care: Reducing Central Line–Associated Bloodstream Infections on a Hematologic Malignancy and Stem Cell Transplant Unit
Background: Patients with hematologic malignancies and stem cell transplant recipients are at increased risk for infections because of their prolonged periods of profound neutropenia. Central line–associated bloodstream infections (CLABSIs) can result in lengthy hospitalizations, increased healthcare costs, and increased morbidity and mortality.
Objectives: The aim of this comprehensive educational training program was to reduce CLABSI rates by focusing on the standardized practices associated with use, care, and maintenance of all types of central lines.
Methods: A pretest was administered to nursing staff. Based on the responses, an education program was then created. The program consisted of a comprehensive two-hour class using different modalities of teaching, including standardized practices associated with central line care.
Findings: The comprehensive education program was effective in standardizing education and improving knowledge gaps, resulting in the reduction of CLABSI rates. Overall, staff knowledge surrounding central line care and maintenance increased by 16%. In addition, no CLABSI events have been reported on the unit from the time of program initiation.
Source taken from ONS Journal
Discussion Starting Points:
Please choose two for your response:
How does this research article compare to our practice, policy and or procedure?
What are the advantages and disadvantages to the proposed recommendations in the article?
What are the advantages and disadvantages of implementing the article recommendations on your unit and/or hospital?
Was the correct method used? Why or why not?
How does this research article compare to our practice, policy and or procedure?
ReplyDeleteAt PSJMC we do have policies regarding standardized practices associated with use, care and maintainance of all types of central lines, wat we lack a comprehensive educational training program to implement these standardized throughout the caregivers/nurses across the hospital. Our current practice right now is only giving minimal educational to oncology nurses in 6NE which in my opinion is not enough practice prevent CLABSI in our immunocrompromised patients.
Was the correct method used? Why or why not?
I strongly believe that the correct method was used. Based on the outcome of this study, I would also recommend a comprehensive class using different modalities of teaching, including standardized practices associated with central line care. My recommendation os to incorporate this with our annual skills fair/ This would given the nurses the confidence and will be more efficient in caring for central lines and prevent CLABSI for the greater good of our patients.
How does this research article compare to our practice, policy and or procedure?
ReplyDeletePSJMC has a policy of central lines care and maintenance and nurses are required to attend annually skills fair for the purpose of educational training of central line and port catheters care. In additions, because of the high prevalence of CLABSI in our hospital last year we are auditing CL the need to use, care and maintenance documentation and visual auditing of CL dressing care, and tubing maintenance. With all that, our nurses have more awareness and the risks of CLABSI are reduced. Our nurses are well trained but more education is always beneficial, specially for the new nurses. At the UBC meeting our manager announced that there will be additional training for nurses on other units at our hospital which is definitely needed.
The advantages of this proposal have a huge benefit for the patient's safety, satisfaction, hospital costs, and nurses productivity. Nurses that are well trained have better confidence in their abilities. Able to perform a task without hesitance or help of others. Can train other nurses. Confident nurses can build trusting relationship with patients and their families.
There are only advantages of educational training to nurses.
by Marzenna Messina
How does this research article compare to our practice, policy and or procedure?
ReplyDeleteOur hospital does have policies in place to reduce CLABSI such has CHG baths and standard practices on maintenance on all types of central lines. Central line audits ensures that every patient with a central line is being assessed and maintained appropriately, such as ensuring dressings are clean dry and intact and CHG baths have been completed. Although the policy discusses all types of central lines and audits are being done on the floors, further teaching should be provided in regards to ports. All other departments such as telemetry and ICU receive oncology patients that are neutropenic.
Was the correct method used? Why or why not?
This method was correct. Based on the study, there should be additional education provided throughout the hospital in regards to taking care of not only PICC lines but port-a-caths. Based of this study, patients with hematologic malignancies are at increased risk for infection due to neutropenia and more education needs to be provided throughout the hospital to improve knowledge gaps to reduce CLABSI rates.
What are the advantages and disadvantages to the proposed recommendations in the article?
ReplyDeleteA standardized education program is a huge advantage for preventing CLABSI because it makes sure every nurse gets the same, high-quality training. This consistency closes knowledge gaps and reduces mistakes in care that can cause infections. With this unified training, nurses become more confident and skilled at following the CLABSI Prevention Bundle. In the end, this leads to safer, better central line care and a real reduction in infections, which is better for everyone.
How does this research article compare to our practice, policy and or procedure?
PSJMC has established central line policies, yet lacks a comprehensive, hospital-wide educational program to ensure consistent implementation. The current minimal training, limited to 6NE oncology nurses, is insufficient for effective Central Line-Associated Bloodstream Infection (CLABSI) prevention, particularly for immunocompromised patients. A standardized training initiative is crucial to elevate care practices across all staff.
How does this research article compare to our practice, policy and or procedure?
ReplyDeleteThe outcome of this study is similar to the outcome that we have on our unit. We have implemented
audits that look into the care of central venous catheters, and we conduct regular refresher classes for staff on how to care and maintain CVC's properly. This resulted in the decrease in the incidence of CLABSI's on our unit's PI measures.
What are the advantages and disadvantages to the proposed recommendations in the article?
ReplyDeleteThe advantage of this study is simply better patient outcome. Increasing staff knowledge in the care of CVC's will result in less incidence of CLABSI.The article's findings "The comprehensive education program was effective in standardizing education and improving knowledge gaps, resulting in the reduction of CLABSI rates." is not applied in our work environment. The comprehensive education program is not administered to other units, and so, there is still a knowledge gap. If a patient who has hematologic malignancy ends up on another unit, and the staff i not knowledgeable how to "ideally" care for the central line, the patient will have a higher risk of developing blood borne infections.
How does this research article compare to our practice, policy and or procedure?
ReplyDeleteWe already practice proper central line care using daily CHG baths on our unit to prevent incidents of CLABSIs.
What are the advantages and disadvantages to the proposed recommendations in the article?
The advantage of assessing the staff’s prior knowledge of how CHG baths should and how often be implemented fills in the gaps of where re education needs to be enforced. In doing so, it will create a standard of care and increase patient safety by decreasing the risk of CLABSIs. A disadvantage would be how compliant a patient will be with our central line care policy. This can be due to altered mental status, combativeness or the patient simply will just be non compliant despite numerous attempts at education.
How does this research article compare to our practice, policy, and/or procedure?
ReplyDeleteThe article is similar to our procedure as we have an annual competency test/check off to ensure we know how to do dressing changes. However, this article proposes a comprehensive two-hour class, which increased staff knowledge by 16%. They administered a pretest to staff to gauge their current knowledge then tailored their education class to the gaps.
What are the advantages and disadvantages to the proposed recommendations in the article?
The only disadvantage to the recommendation in this article is the time and money spent getting a two-hour class together. The big advantage of the recommendation is reduction in the incidence of CLABSI events. Educating the staff would empower them to do more competent work and promote patient safety.
How does this research article compare to our practice, policy, and/or procedure?
ReplyDeleteThe article is similar to what we do because we also have a yearly skills check to make sure staff know how to do dressing changes. The difference is that this article suggests a two hour class, which improved staff knowledge by 16%. They gave staff a pretest first, then built the class around the areas where knowledge was lacking.
What are the advantages and disadvantages of the proposed recommendations in the article?
The downside is that planning and running a two hour class takes extra time and money. The benefit is that it can lower the number of CLABSI cases. Staff would feel more confident in their skills, and patients would be safer.