(559) Enhancing Nurse Adherence to CLABSI Prevention Bundles: A Systematic Review

Introduction: The number of cases of central line-associated bloodstream infections (CLABSIs) in intensive care units (ICUs) is increasing, which is partly attributed to the lack of adherence to CLABSI bundles. This systematic review aims to synthesize the evidence about effective strategies to improve nurses' adherence to CLABSI prevention bundles.

Methods: The review involved searching five databases: CINAHL, MEDLINE, PubMed, Cochrane Library, and SCOPUS. Studies that investigated adherence to central line guidelines, and strategies for improving adherence within ICU settings were considered eligible. The literature published between 2012 and 2024 was searched and was restricted to English-language studies. Two reviewers independently performed the screening, critical appraisal and data extraction using Joanna Briggs Institute (JBI) tools. The review protocol was registered on PROSPERO (CRD42024513345). Meta-analysis was not possible due to clinical and methodological heterogeneity

Results: The search resulted in 11264 studies, of which 93 were supplicates. The reaming 1171 studies were screened for title and abstract of which 1143 were excluded and 28 studies were screened for full text. Twenty-one studies were excluded and 7 studies met the inclusion criteria for this review, comprising four quality improvement projects and three quasi-experimental studies. The quality of the relevant studies ranged from moderate to high (68.75% to 88.88%). Strategies that were found effective in improving nurses' adherence with CLABSI prevention bundles included educational programs, leadership initiatives, improved documentation practices, and better resource allocation.

Conclusions: The adoption of targeted strategies led to significant improvements in nurses' adherence to CLABSI prevention protocols. Future research should focus on long-term adherence assessments, and the role of organizational culture and leadership in protocol adherence.