Development of Infection Control and Preventive Nursing Assessment Tool for Central Line-associated Bloodstream Infection (ICPNAT for CLABSI) in Selected Hospitals in China: An Exploratory Sequential Mixed Methods Study

Background Extended hospital stays, higher hospital costs, and increased mortality are common central line-associated bloodstream infection (CLABSI) outcomes. Nurses' roles in preventing CLABSI are vital. Improving patient outcomes requires action to ensure intensive care unit (ICU) nurses' strict adherence with nursing practice guidelines. Aim To develop and validate a nursing assessment tool to enhance CLABSI prevention and infection control in Chinese ICUs. Study Design We employed an exploratory sequential mixed-methods design using a three-stage sequential procedure: phase 1, an exploratory descriptive design involving interviews with 15 nurse experts and analysis using the Colaizzi method; phase 2, tool development and evaluation, including rigorous assessment of internal consistency and reliability via Cronbach's α and split-half test; and phase 3, a descriptive design applying the newly developed tool to 183 registered nurses in China. We evaluated demographic variable effects using one-way analysis of variance and independent samples t-tests. Results The six themes of the CLABSI assessment tool covered the entire central venous catheter insertion and maintenance processes. The themes' weighted mean values were 4.57, 4.51, 4.49, 4.38, 4.37, and 3.86 for innovation for maintenance, innovation for replacement of infusion sets, innovation for cannulation procedure, internal environment, recipient, and external environment, respectively. The overall weighted mean of the tool was 4.43. Conclusions The CLABSI assessment tool was highly accepted by ICU nurses. Most items align with current evidence-based guidelines. Some items reflect interventions proven effective in clinical practice, even exceeding guideline recommendations.