How Central Line Guideline Adherence and Application Impacts Patient Outcomes
Abstract
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.
