Harnessing implementation science to optimize harm prevention in critically ill children: A pilot study of bedside nurse CLABSI bundle performance in the pediatric intensive care unit.
• Central-line associated bloodstream infections (CLABSIs) have serious negative consequences. • Compliance by nurses with a bundle to prevent CLABSI is suboptimal. • Implementation and behavioral science offer new insights into why compliance is challenging. • Strategies that facilitate opportunity...
| Publicado en: | American Journal of Infection Control Vol. 49; no. 3; pp. 345 - 352 |
|---|---|
| Autores principales: | , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Elsevier B.V.
Mar2021
|
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=148930242&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 148930242 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 01966553 44Q jtl: American Journal of Infection Control issn: 01966553 maglogo: N pubinfo: dt: Mar2021 vid: 49 iid: 3 pid: 467 pub: Elsevier B.V. place: New York, New York artinfo: ui: 148930242 148930242 148930242 10.1016/j.ajic.2020.08.019 148930242 ppf: 345 ppct: 7 formats: tig: atl: Harnessing implementation science to optimize harm prevention in critically ill children: A pilot study of bedside nurse CLABSI bundle performance in the pediatric intensive care unit. aug: au: Woods-Hill, Charlotte Z. Papili, Kelly Nelson, Eileen Lipinski, Kathryn Shea, Judy Beidas, Rinad Lane-Fall, Meghan affil: Division of Critical Care Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA sug: subj: Critically Ill Patients In Infancy and Childhood Harm Reduction In Infancy and Childhood Catheter-Related Bloodstream Infections Prevention and Control Catheter-Related Bloodstream Infections Nursing Implementation Science Human Child Pilot Studies Intensive Care Units, Pediatric Infection Control Cross Sectional Studies Pennsylvania Surveys Descriptive Statistics Data Analysis Software Male Female Child: 6-12 years Male Female ab: • Central-line associated bloodstream infections (CLABSIs) have serious negative consequences. • Compliance by nurses with a bundle to prevent CLABSI is suboptimal. • Implementation and behavioral science offer new insights into why compliance is challenging. • Strategies that facilitate opportunity and optimize motivation may improve bundle compliance. Central-line associated bloodstream infection (CLABSI) is associated with increased mortality, morbidity, and cost in hospitalized children. An evidence-based bundle of care can decrease CLABSI, but bundle compliance is imperfect. We explored factors impacting bundle performance in the pediatric intensive care unit (PICU) by bedside nurses. Single-center cross-sectional electronic survey of PICU bedside nurses in an academic tertiary care center; using the COM-B (capability, opportunity, motivation) and TDF (theoretical domains framework) behavioral models to explore CLABSI bundle performance and identify barriers to compliance. We analyzed 160 completed surveys from 226 nurses (71% response rate). CLABSI knowledge was strong (capability). However, challenges related to opportunity were identified: 71% reported that patient care requirements impact bundle completion; 32% described the bundle as stressful; and CLABSI was viewed as the most difficult of all bundles. Seventy-five percent reported being highly impacted by physician attitude toward the CLABSI bundle (motivation). PICU nurses are knowledgeable and motivated to prevent CLABSI, but face challenges from competing clinical tasks, limited resources, and complex family interactions. Physician engagement was specifically noted to impact nurse motivation to complete the bundle. Interventions that address these challenges may improve bundle performance and prevent CLABSI in critically ill children. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
|---|