Facilitators and barriers to evidence-based practice in central venous access device insertion and management in an intensive care unit: a qualitative study

Frances Fengzhi Lin; Niki Murphy; Angelly Martinez; Andrea P. Marshall

doi:10.1016/j.iccn.2023.103553

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Facilitators and barriers to evidence-based practice in central venous access device insertion and management in an intensive care unit: a qualitative study

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Facilitators and barriers to evidence-based practice in central venous access device insertion and management in an intensive care unit: a qualitative study

Frances Fengzhi Lin, Niki Murphy, Angelly Martinez and Andrea P. Marshall

Intensive and Critical Care Nursing, Vol.80, pp.1-6

2023

DOI: https://doi.org/10.1016/j.iccn.2023.103553

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Abstract

barriers

central venous access device

clinical practice guidelines

facilitators

infection

prevention

Introduction: Research evidence and clinical practice guidelines exist on preventing central line-associated bloodstream infections. However, there is limited knowledge about the barriers and facilitators to evidence-based central venous access device care. Aim: The aim of this study was to investigate the facilitators and barriers to evidence-based central venous access device care in the adult intensive care setting. Method: This exploratory qualitative study involved focus groups and interviews with registered nurses and physicians involved in central venous access device insertion and management in a tertiary Australian intensive care unit. Purposive sampling was used to recruit staff (n = 26) with varying years of clinical experience and clinical positions. Six focus groups and three individual interviews were conducted. Interviews were audio recorded, transcribed verbatim and analysed using content analysis. Results: Three overarching categories emerged: work structures to support optimal performance; processes to optimise quality of care, and factors influencing staff members’ behaviour. Perceived facilitators to optimal central venous access device care included explicit language use in procedure documents, work-system integrated strategies, research evidence dissemination, audit, and feedback. However, there was a lack of consistency in practices such as audit, feedback, and patient participation. Conclusion: To bring about effective improvement in central venous access device care, future interventions should be tailored to address identified barriers, including integrating audit and feedback into clinicians’ work processes. Additionally, future research is needed to explore the role of patients and their families in central venous access device care.

Details

Title: Facilitators and barriers to evidence-based practice in central venous access device insertion and management in an intensive care unit: a qualitative study
Authors: Frances Fengzhi Lin (Corresponding Author) - University of the Sunshine Coast, Queensland, School of Health - Nursing
Niki Murphy (Author) - Gold Coast Hospital
Angelly Martinez (Author) - Gold Coast Hospital
Andrea P. Marshall (Author) - Griffith University
Publication details: Intensive and Critical Care Nursing, Vol.80, pp.1-6
Publisher: Elsevier Ltd
Date published: 2023
DOI: 10.1016/j.iccn.2023.103553
ISSN: 1532-4036; 0964-3397
Copyright note: This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
Grant note: Australian College of Critical Care Nurses Queensland Griffith University
Organisation Unit: School of Health - Nursing; University of the Sunshine Coast, Queensland
Language: English
Record Identifier: 99971196502621
Output Type: Journal article

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