An audit of central venous catheter insertion and management practices in an Australian tertiary intensive care unit: A quality improvement project

Frances Fengzhi Lin, Niki Murphy, Angelly Martinez, Andrea Marshall

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)

Abstract

Introduction: Central venous catheters are often used in managing critically ill patients. Clinical practice guidelines and care bundles exist to prevent central line associated blood stream infections; however, detailed adherence to these guidelines and care bundles is unclear. 

Aim: This study was aimed to describe clinicians’ adherence to recommended practices in central venous catheter insertion and management. 

Method: A cross-sectional prospective observational study was conducted in the intensive care unit of an Australian tertiary hospital over a four-month period. We observed a total of 50 nurses during post insertion management, and 10 physicians during central venous catheter insertion using purposely designed observation tools. 

Results: Our audit identified 90% adherence to recommended practices in central venous catheter insertion and 60% to post insertion management. However, there were areas where participants’ practices were not congruent with evidence-based recommendations, including choice of central venous catheter insertion site, type of central venous catheters, dressing choice, aseptic technique, and documentation. 

Conclusion: Our audit showed a detailed picture of clinician's adherence to recommended practices in central venous catheter insertion and management. A clearer understanding of the barriers and facilitators of issues identified is needed to inform the design of future interventions to reduce central line related blood stream infections in the unit.

Original languageEnglish
Article number103217
Number of pages6
JournalIntensive and Critical Care Nursing
Volume70
DOIs
Publication statusPublished - Jun 2022
Externally publishedYes

Keywords

  • Adherence
  • Audit
  • Care bundles
  • Central line associated bloodstream infection
  • Central venous catheter
  • Clinical practice guidelines
  • Intensive care

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