Date of Conferral
12-23-2025
Date of Award
December 2025
Degree
Doctor of Nursing Practice (DNP)
School
Nursing
Advisor
Dr. Robert McWhirt
Abstract
Central line-associated bloodstream infections (CLABSIs) remain a significant and preventable patient safety issue, especially among hospitalized patients receiving total parenteral nutrition (TPN). Patients on TPN face a higher risk of infection due to the high glucose content of the solution and the frequent access required for central line therapy. The Centers for Disease Control and Prevention and the Agency for Healthcare Research and Quality have recognized CLABSI prevention as a national priority. In addition, there is emphasis on high-risk groups like patients receiving TPN. The Infusion Therapy Standards of Practice, an evidence-based guideline, recommends catheter care, including timely adapter (i.e., clave) changes, to reduce the risk of infection. Observations at the project site and quality data revealed inconsistent practice with adapter changes, demonstrating a need for a practice intervention. Data from the last 2 fiscal years at the project site indicated that in fiscal year 2024, there were four CLABSIs outside the intensive care unit (ICU) setting, two involving patients on TPN, resulting in a rate of 0.32 per 1,000 central line days. Furthermore, in fiscal year 2025, there was one patient outside the ICU setting that involved a patient on TPN for a rate of 0.08. The evidence-based practice question addressed whether a staff education program on adapter changes of central line patients on TPN would increase staff knowledge towards the goal of reducing central line-associated bloodstream infection. The results demonstrated effectiveness with 21 of 22 participants having higher posttest scores with a mean 29.48 percentage point increase in scores from pre- to posttest. Implementing a structured staff education project is a crucial step in reducing preventable CLABSIs and improving patient outcomes for this low-volume, high-risk population .
Recommended Citation
Schappell, Courtney Erin, "Adapter Changes of Central Line Patients on Total Parenteral Nutrition" (2025). Walden Dissertations and Doctoral Studies. 18610.
https://scholarworks.waldenu.edu/dissertations/18610
