Reducing Central Line-Associated Bloodstream Infections in ICUs: A Systematic Review of Barriers and Facilitators and Intervention Measures.
Huiqin Shi, Jingying Huang, Kailai Gu et al.
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In 30 seconds
This PRISMA-guided systematic review examined barriers and facilitators to implementing central line-associated bloodstream infection (CLABSI) prevention among ICU healthcare workers. It included 28 qualitative, quantitative, or mixed-methods studies identified from 1,780 records. Using the Consolidated Framework for Implementation Research, the authors synthesized 28 determinants into four themes and 16 constructs. Prominent barriers included staff knowledge gaps, inconsistent adherence to recommended practices, limited resources, and insufficient leadership support. Mapping to expert recommendations identified 11 Level 1 implementation strategies: four appeared in the included literature, while seven were potential implementation gaps.
Key findings
- The review included 28 studies and synthesized 28 barriers and facilitators into four themes and 16 CFIR constructs.
- Prominent barriers were staff knowledge gaps, inconsistent adherence to recommended practices, limited resources, and insufficient leadership support.
- Of 11 Level 1 expert-endorsed strategies identified through CFIR-ERIC mapping, four were represented in the literature and seven were potential gaps.
Why it matters
The findings frame CLABSI prevention as an implementation challenge shaped by individual, organizational, and practice-related factors, not simply by the availability of guidelines. Identifying local barriers may help organizations select more relevant approaches to support consistent prevention practices and patient safety in ICUs.
What to keep in mind
The review’s findings depend on the included studies and their quality; the abstract does not report a pooled estimate of intervention effectiveness.