Date of Award

Summer 2022

Document Type

Final DNP Paper

Degree Name

Doctor of Nursing Practice (DNP) in Adult-Gerontology Acute Care Nurse Practitioner

Department

Nursing

Faculty Chair

Dr. Heather Wallace

Preceptor

Dr. Leland Allen

Abstract

Background: Quality improvement efforts from an urban facility have observed a need for staff education on the central line maintenance bundle and consistent surveillance with the Central Line Maintenance Evaluation Tool (CLMET).

Purpose: To address the practice gap of central line maintenance bundle usage at the bedside by utilizing the CLMET consistently.

Methods: A voluntary didactic program offered to staff and encouraging daily utilization of the CLMET that included real-time feedback by the supervisors.

Results: Pretest grade for the unit (n=13, 82.06) and the post-test grade (n=13, 86.33), which is + 4.27 points after education. Pre-implementation, January 1st through 31st, 2022, of the 31 days available, only 17 of those days the CLMET were completed. There were a total of 70 bundle opportunities noted on those 17 days. The compliance rate for January (n=20, 28.57%). Implementation from February 1st through 28th, 2022, with the patient care supervisors’ daily use of the CLMET with real-time feedback of the missed bundle components. The results are as follows; of the 28 days of the daily CLMETs, there were only documented central line data on 14 of the days. From the CLMETs completed, there were 114 central line opportunities to meet bundle completion. The compliance rate for February (n=43, 37.72%).

Conclusion: Even though the inconsistency of the CLMET being utilized was noted in both January and February and not every nurse participated in the didactic there was still an increase of 9.15% in bundle compliance in the unit of focus, and zero CLABSIs for the months of February and March 2022.

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