Qualitative analysis of central and midline care in the medical/surgical setting.
OBJECTIVE
Community hospital medical-surgical nurses have a limited understanding of the complexities of preventing central line-associated bloodstream infections (CLABSIs). The purpose of this study was to look at the phenomenon of central line care from a human perspective and to develop an understanding of the lived experience as it relates to nursing care.


METHODS
A qualitative, phenomenology framework was applied for this study.


METHODS
The study was performed at a seasonally fluctuating, 400- to 600-bed community hospital in southwest Florida.


METHODS
Fifteen full-time medical-surgical bedside registered nurses, 8 working the 12-hour day shift and 7 working the 12-hour night shift, were interviewed.


METHODS
Experiences from recorded, 45-minute, in-depth telephone interviews from nurses assigned to 4 medical-surgical units, with the greatest CLABSI frequency, were analyzed.


RESULTS
Findings identified myriad challenges when it comes to administering proper technique and preventing CLABSIs. The themes, time and locus of responsibility, patient population and unit, and variations in experience with CLABSIs, are illuminated.


CONCLUSIONS
Nurses have strong feelings and suggestions for organizations to consider in reducing infection rates. Line care education should focus on the relationship of the nurse to understanding CLABSIs, education on line care, supplies, and charting/documentation.


CONCLUSIONS
The revealed nature and meaning of the human experience of the central line dressing change and skill actions, identified by the nurses, were brought to the CLABSI committee, and a plan was formed. Six months after implementation of the plan, based on the nurses' lived experiences, the rate of infections has dropped 64%.
NCH Healthcare System, Naples, Florida 34119, USA. sycamore5333@gmail.com
Theresa
T
Morrison
D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D016470:Bacteremia / Q000209:etiology / Q000517:prevention & control*; D055499:Catheter-Related Infections / Q000209:etiology / Q000517:prevention & control*; D002405:Catheterization, Central Venous / Q000009:adverse effects; D002408:Catheters, Indwelling / Q000009:adverse effects; D002983:Clinical Competence; D015400:Clinical Nursing Research; D005260:Female; D005431:Florida; D006757:Hospital Units; D006764:Hospitals, Community; D006801:Humans; D008875:Middle Aged; D015403:Nursing Evaluation Research; D015404:Nursing Methodology Research; D009741:Nursing Staff, Hospital / Q000523:psychology*; D036301:Qualitative Research; D011785:Quality Assurance, Health Care / Q000458:organization & administration*; D013503:Surgery Department, Hospital