title: Facilitating central line-associated bloodstream infection prevention: a qualitative study comparing perspectives of infection control professionals and frontline staff.
abstract: BACKGROUND
  Infection control professionals (ICPs) play a critical role in implementing and managing healthcare-associated infection reduction interventions, whereas frontline staff are responsible for delivering direct and ongoing patient care. The objective of our study was to determine if ICPs and frontline staff have different perspectives about the facilitators and challenges of central line-associated bloodstream infection (CLABSI) prevention program success.
  
  
  METHODS
  We conducted key informant interviews at 8 hospitals that participated in the Agency for Healthcare Research and Quality CLABSI prevention initiative called "On the CUSP: Stop BSI." We analyzed interview data from 50 frontline nurses and 26 ICPs to identify common themes related to program facilitators and challenges.
  
  
  RESULTS
  We identified 4 facilitators of CLABSI program success: education, leadership, data, and consistency. We also identified 3 common challenges: lack of resources, competing priorities, and physician resistance. However, the perspective of ICPs and frontline nurses differed. Whereas ICPs tended to focus on general descriptions, frontline staff noted program specifics and often discussed concrete examples.
  
  
  CONCLUSIONS
  Our results suggest that ICPs need to take into account the perspectives of staff nurses when implementing infection control and broader quality improvement initiatives. Further, the deliberate inclusion of frontline staff in the implementation of these programs may be critical to program success.
authors.affiliation: Department of Family Medicine, College of Medicine, The Ohio State University, Columbus, OH; Division of Health Services Management and Policy, College of Public Health, The Ohio State University, Columbus, OH. Electronic address: ann.mcalearney@osumc.edu.
authors.forename: Ann Scheck
authors.initials: AS
authors.lastname: McAlearney
authors.affiliation: Department of Family Medicine, College of Medicine, The Ohio State University, Columbus, OH.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Hefner
mesh_terms: D016470:Bacteremia / Q000517:prevention & control; D055499:Catheter-Related Infections / Q000517:prevention & control*; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D003428:Cross Infection / Q000517:prevention & control*; D003625:Data Collection; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D017053:Infection Control / Q000379:methods*; D007362:Intensive Care Units; D009726:Nurses; D061214:Patient Safety; D010818:Practice Patterns, Physicians'; D058996:Quality Improvement; D057566:Self Report
keywords: HAI prevention; Health services research; Quality improvement