Article type
Abstract
"Background: Central venous catheters (CVCs) are widespread application during the treatment of critically ill patients. Central line-associated bloodstream infection (CLABSI) is one of its most serious complications. Although evidence-based practices for the prevention of CLABSI have been established, compliance with best evidence remains a challenge for nurse. The aim of this study was to evaluate the effectiveness of implementing the evidence in preventing CLABSI in pediatric intensive care unit (PICU) and to understand the utility of the integrated Promoting Action on Research Implementation in Health Services (i-PARIHS) framework as a prospective tool for implementation.
Methods: A pre- and post-implementation study was conducted to prevent CLABSI in PICU. The Joanna Briggs Institute Practical Application of Clinical Evidence System (JBI PACES) tool will be used. The JBI PACES for promoting evidence-based healthcare involves three phases of activity. First, a baseline audit. In a second phase, feedback will be given to the project team after the conclusion of the baseline audit report. In this phase, the i-PARIHS framework was used to identify best evidence implementation barriers and enablers to inform facilitation support strategies, such as providing education and technical support for nurse, building relationships, teams, and system, giving audit and feedback. Then, a third phase will be conducted as a follow-up audit.
Results: After application of the evidence-based strategies, the knowledge score of CVC maintenance (53.55±5.941) was significantly higher than baseline audit (23.38±6.124) (P<0.01). CVC maintenance compliance after evidence application was significantly higher than baseline audit before evidence application (P<0.05). The incidence of indwelling catheter dysfunction after evidence application (25%) was significantly lower than at baseline audit before evidence application (83.87%) (P<0.001).
Conclusion: The evidence implementation of CVC maintenance based on i-PARIHS framework can effectively improve the knowledge level and compliance of CVC maintenance of PICU nurses, reduce the incidence of CVC complications, and promote the transformation of evidence to clinical practice. The i-PARIHS framework supported effective implementation of the evidence in preventing CLABSI, narrowing the gap between evidence and clinical practice."
Methods: A pre- and post-implementation study was conducted to prevent CLABSI in PICU. The Joanna Briggs Institute Practical Application of Clinical Evidence System (JBI PACES) tool will be used. The JBI PACES for promoting evidence-based healthcare involves three phases of activity. First, a baseline audit. In a second phase, feedback will be given to the project team after the conclusion of the baseline audit report. In this phase, the i-PARIHS framework was used to identify best evidence implementation barriers and enablers to inform facilitation support strategies, such as providing education and technical support for nurse, building relationships, teams, and system, giving audit and feedback. Then, a third phase will be conducted as a follow-up audit.
Results: After application of the evidence-based strategies, the knowledge score of CVC maintenance (53.55±5.941) was significantly higher than baseline audit (23.38±6.124) (P<0.01). CVC maintenance compliance after evidence application was significantly higher than baseline audit before evidence application (P<0.05). The incidence of indwelling catheter dysfunction after evidence application (25%) was significantly lower than at baseline audit before evidence application (83.87%) (P<0.001).
Conclusion: The evidence implementation of CVC maintenance based on i-PARIHS framework can effectively improve the knowledge level and compliance of CVC maintenance of PICU nurses, reduce the incidence of CVC complications, and promote the transformation of evidence to clinical practice. The i-PARIHS framework supported effective implementation of the evidence in preventing CLABSI, narrowing the gap between evidence and clinical practice."