Date of Award
11-3-2023
Document Type
Dissertation
Degree Name
Master of Science in Nursing (MScN)
First Supervisor/Advisor
Dr. Naghma Rizvi
Second Supervisor/Advisor
Ms. Arusa Lakhani
Department
School of Nursing and Midwifery, Pakistan
Abstract
Background: CLABSI’s are serious healthcare-associated infections resulting from central venous catheters which are predominantly used in ICUs. Nurses, as frontline caregivers, play a critical role in preventing CLABSIs. Their views often highlight the importance of strict protocols, vigilance, and teamwork to minimize CLABSI risks, enhancing patient safety. Studies in low-middle countries like, Pakistan till yet have focused on investigation CLABSI incidents, knowledge of it and associated factors. From a unit with a long-term record of being free from CLABSIs can offer valuable insights into identifying best practices, replicating them, and understanding the obstacles involved in achieving a CLABSI-free environment.
Objectives: The purpose of this study was to explore nurses' views on practices followed during nine months that contributed to maintaining successful CLABSI-free rates in the medical ICU of tertiary care hospital, in Karachi, Pakistan.
Methods: Exploratory-descriptive qualitative method was used, and 12 registered nurses were interviewed who worked/working in medical ICU during nine months CLABSI-free period.
Results: Three main themes identified: (1) need-based capacity building process, (2) collaborative synergy and, (3) challenges and proposed solutions. The theme “need-based capacity building process” emerged from the subtheme: case-based reflective learning; strengthening of skills; improvement of CLABSI bundle compliance which depicts the assessment and initial phase of CLABSI free initiatives. The second theme “collaborative synergy” derived from the subtheme: active operational team; self-efficacy which reflected the active intervention phase by multi-disciplinary team in achieving zero CLABSI target. The third theme aroused as “challenges and proposed solution” derived from the subthemes: impact on routine and harmony; patient suffering; and recommendation for sustainability. This theme mirrored the hardships faced by both health care workers and the patients who encountered zero CLABSI phase and the recommendations offered by the participants to avoid those challenges in future.
Conclusion: In conclusion targeted interventions based on learning needs and active participation of multidisciplinary team can reduce CLABSIs. Moreover, to achieve and maintain CLABSI free unit there are associated challenges which are mainly encountered by those who are directly involved in it hence, they should be assessed continuously and addressed timely.
Recommended Citation
Islamuddin, S. (2023). The experiences of nurses regarding practice change in maintaining nine months CLABSI-free medical intensive care unit: A qualitative study at a tertiary care hospital, Karachi, Pakistan (Unpublished master's dissertation). .