Central Venous Line Bundle Interventional Program: Effects on Patients’ Health Outcomes

Background: Central venous line-associated bloodstream infection is an important healthcare-associated infection in the critical care units. It causes substantial morbidity, mortality and incurs high costs. The use of a central venous line insertion bundle has been shown to decrease the incidence of infection. Method: The current study is a quasi-experimental study with pre-post assessment was utilized to achieve the aim of the study carried out in the cardio-thoracic Intensive Care Units affiliated to Ain Shams University Hospital. The study involved a health care team group (50 nurses and 27 physicians) and 220 patients (110 pre and 110 posts). Five data collection tools were used, namely physicians and nurses' assessment tools, observation checklist for nurse's practice, central venous catheter insertion audit tool, patient assessment sheet, and unit policy assessment checklist. The researcher developed a training program based on the findings of the assessment and implemented it to participants. The effect of the program was evaluated by comparing post with pre-intervention phase findings. Findings: Overall, all patients had some type of infection before the intervention, compared to 69.1% after the intervention (p<0.001). The lower mean of hospital stay in the post (6.0±0.1 days) compared to the pre (8.7±0.6 days) sample, (p<0.001). Conclusion: The implementation of a training program in the CVL bundle based on their identified needs is successful in effecting significant improvements in their knowledge and performance. This is positively reflected on patient outcomes as assessed by observation for local and systemic signs of infections, and objectively through microbiological cultures.