Date of Graduation

Fall 12-18-2015

Document Access

Project/Capstone - Global access

Degree Name

Master of Science in Nursing (MSN)


School of Nursing and Health Professions

First Advisor

Danijela Pavlic


Central line-associated bloodstream infection (CLABSI) is a significant problem in a Level IV neonatal intensive care unit (NICU) on the West Coast of California. A clinical nurse leader (CNL) student joined a team consisting of the unit’s nursing manager, nursing educator, clinical nurse specialist (CNS), and CNS student. Literature review highlighted the association between the development of CLABSI and the practice of changing central line intravenous (IV) tubing. Five interviews of nurses and 15 observations of nurses performing IV tubing change revealed practice variations within six major steps of the procedure. The team revised the IV tubing change policy to improve comprehension and feasibility and then educated nurses on the changes. The team sought to eliminate variations and standardize practice by designing a competency for IV tubing change that requires all nurses to perform the procedure as an instructor observes for accuracy with every step of the new policy. Evaluation of the competency is ongoing, but follow up questions include: (1) Have all nurses successfully passed the competency? (2) Are nurses maintaining compliance with the new policy after completion of the competency? (3) Has the CLABSI rate decreased in response to the competency?