Implementation Science: Implementation Methods Used by Pediatric Intensive Care Units in a National Collaborative

Abstract

Abstract Problem Statement: In 2001, the Committee on Quality in Health Care in America found it took 17 years for evidence from randomized controlled trials to be applied to practice. There has been little improvement over the last decade, despite the national approach to package evidence-based practices into abbreviated formats. Even summarized evidence fails to be consistently implemented at the bedside. More emphasis needs to be placed on understanding, which Implementation Methods are most effective in successfully implementing evidence-based practice at the bedside. Aims: The purpose of the study was to examine Implementation Strategies, Methods, and Dimensions used by 57 Pediatric Intensive Care Units (PICUs) participating in the National Association of Children's Hospitals and Related Institutions (NACHRI, 2011) collaborative to eliminate central line associated blood stream infections (CLABSI) in critically ill children. Methods: This descriptive research study was conducted using survey methods and retrospective outcome data. The relationships between Implementation Dimensions and three outcomes of central line insertion bundle compliance, central line maintenance bundle compliance, and CLABSI rate were explored with the computation of correlations and bivariate regression analysis. Findings: Most Implementation Methods had high or very high use across the 57 PICUs. There were no significant correlations or predictive relationships between any of the Implementation Dimensions and any of the three outcomes of central line insertion bundle compliance, central line maintenance bundle compliance, or CLABSI rate. Implementation Science: Implementation Methods Used by Pediatric Intensive Care Units in a National Collaborative Debra A. Ridling Chair of the Supervisory Committee: Professor Diane Magyary School of Nursing