The Effectiveness of a Central Line Care and Maintenance Bundle to Promote Consistency and Compliance in Central Line Care

Graduation Date


Document Type

Master's Thesis

Document Form


Degree Name

Master of Science



Department or Program Chair

Eira Klich-Heartt, RN, MSN

Thesis Advisor

Eira Klich-Heartt, RN, MSN


Catheter related blood stream infections, also known as CRBSIs, are one of the many preventable hospital acquired infections. CRBSIs directly affect mortality rate among hospitalized patients across the nation. Traditionally, the focus has been on preventing CRBSIs during central line insertion by implementing evidence based practices (EBPs) in the form of “central line insertion bundles”. The theme of this capstone project was to implement 'central line care and maintenance bundle' by bundling the currently used EBPs. and evaluate its effectiveness to increase consistency and nurses’ compliance with providing central line care. The bundle approach has been proven effective to prevent CRBSIs: especially, when combined with ongoing nursing education on the role of intraluminal and extraluminal biofilm formation in CRBSIs and the importance of providing consistent and timely central line care to prevent such infections.

The project site for this capstone was a community hospital located in the North Bay sub- region of San Francisco bay area. This hospital is licensed for 2a5 acute care beds and is a designated level three-trauma hospital in the area. Currently, this hospital has an evidenced based central line insertion bundle but there is still a need for a post­insertion care and maintenance bundle to promote consistency and compliance in nursing care related to central lines. The timing to implement a care and maintenance bundle at this hospital’s phenomenal secondary to many reasons such as new recommendation to prevent CRBSIs released by the CDC on April 1st,'s infection control

Department recently added two new products to prevent bacterial films from growing at the central line catheter hubs, and the implementation of the shared governance model of nursing. CRBSIs are one of the many hospital-acquired infections. Effective October 2008, the Center of Medicare Services (CMS) does not reimburse the direct cost to treat or any additional hospital cost that occurred as a result of this infection(Hebden, 2009), therefore, the hospital has a financial incentive to prevent CRBSIs by implementing more evidence-based practices as part of its prevention measures. All of the mentioned factors will contribute into a successful implementation of such a care and maintenance bundle.