Date of Doctor of Nursing Practice Project Completion

Spring 4-20-2026

Faculty Advisor

Rebecca Tsusaki

Abstract

PURPOSE 

The aim of this quality improvement (QI) project was to reduce unnecessary central line dwell time by 20% in a surgical intensive care unit (SICU) in Central Texas.

BACKGROUND 

Central line–associated bloodstream infections (CLABSIs) contribute to patient harm and increased healthcare costs. The literature strongly supports the timely removal of central venous catheters (CVCs) to reduce this risk; however, delays often occur due to workflow demands, communication gaps, and inconsistent daily necessity assessments.

METHODOLOGY 

Guided by the Health Belief Model (HBM) and the Institute for Healthcare Improvement (IHI) Model for Improvement, the QI project consisted of an 8-week baseline period (n=84) followed by an 8-week implementation period (n=63). The intervention consisted of placing a visual aid outside each patient’s room to prompt daily reassessment and timely removal of CVCs. Both quantitative and qualitative data were collected and analyzed using descriptive statistics or thematic analysis.

RESULTS 

During the implementation period, the mean unnecessary CVC dwell time with a 24-hour grace period remained essentially unchanged; however, when the grace period was excluded, the mean dwell time decreased by approximately 8%. Compliance with the intervention averaged 68%, and staff surveys indicated favorable perceptions.

IMPLICATIONS 

Overall, the visual aid is a low-cost intervention with strong potential for sustainability and expansion. The intervention improved staff awareness and interdisciplinary communication regarding the necessity of CVCs, thereby enhancing clinical decision-making for their timely removal.

Dwell times observed were primarily among surgical patients and persisted for lengthened periods following transfer from the SICU, highlighting a care gap and an opportunity for improvement.

Keywords

Keywords: central line, central line–associated bloodstream infection, surgical intensive care unit, quality improvement, visual aid

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