Date on Paper


Document Type

Doctoral Paper

Degree Name




Committee Chair

Roser, Lynn P.

Committee Member

Kern, Nancy

Author's Keywords

Bundle compliance; Guideline Adherence; Nursing Interventions; Simulation; Central Line-Associated Bloodstream Infection; Infection Control


Background: Central line-associated bloodstream infection (CLABSI) is the most common healthcare-acquired infection in pediatrics. A pediatric acute care facility in Kentucky created a specialized care team in an effort to track CLABSI bundle compliance and reduce central line infections. While rates of infection decreased, a significant number of infections still occurred and staff adherence to facility evidence-based policies and infection prevention interventions remained low.

Purpose: To reach the facility’s goal of zero central line-associated bloodstream infections, a quality improvement (QI) project was developed to improve staff knowledge of care and increase staff adherence to policy.

Methodology: To create the QI project focused a literature review, and the Institute for Healthcare Improvement (IHI)’s Plan- Do- Study- Act (PDSA) model were used. This project was the first cycle of PDSA, a guide to future cycles.

Intervention: Interventions included initiation of biannual CLABSI educational simulation, distribution of a monthly newsletter, and posting bundle elements at the bedside.

Results: A 2.25% increase in test score from pre to post-test was obtained and scores on many of the questions increased from pre- to post-test. Audits allowed for the calculation of baseline compliance with the facility’s Central Line- Associated Blood Stream Infection prevention bundle, as well as identified areas where compliance was not adequate. Assessment of the unit’s CLABSI infections post-intervention illustrates that although the quality improvement project’s impact on rate of infection cannot truly be determined, the influence on nursing compliance with the CLABSI bundle resulted in a +32.27% of change.

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