How Central Line Guideline Adherence and Application Impacts Patient Outcomes

Barbara Ann Purdon, Walden University


Healthcare-associated infections (HAIs) are a frequent cause of patient morbidity and mortality

and affect hundreds of millions of patients throughout the world annually. Central line-associated

blood stream infections (CLABSIs) are one type of HAIs that contributes to poor patient

outcomes. Properly assessing a central line for patency enables a health care provider to diagnose

a thrombotic occlusion, a common complication of central lines and precursor to infection, to

determine if the assessment includes checking for a brisk blood return. There is a lack of

research assessing the relationship between checking a central line for a brisk blood return and

the resulting rates of CLABSI. Using the theory of social suffering as a framework, the purpose

of this study was to explore the relationship between central line assessment practices and

CLABSI rates. This quantitative case control study included simple and multiple linear

regressions and descriptive statistics to evaluate the 330 CLABSIs reported by 56 hospitals in

Michigan and how the need to assess for a brisk blood return impacted the CLABSI rate at each

institution. Furthermore, the policies and practices of central line assessment were compared

between university- and community-based hospitals, which resulted in no statistical difference;

therefore, the null hypothesis could not be rejected. This study could contribute to positive social

change by encouraging administrators to focus on creating consistent central line maintenance

policies, adoption of these policies and adherence to the policies, in order to decrease the

CLABSIs and improve patient outcomes.