Date of Completion
Fall 2026
Document Type
DNP Scholarly Project
Academic Department
School of Nursing
Degree Type
Doctoral
Degree Name
Doctor of Nursing Practice
First Advisor
Kristie Lowry, DNP, RN
Second Advisor
Kelly Manda, DNP, MSN, FNP-C, RNFA
Abstract
Problem: At the project site, central line-associated bloodstream infection (CLABSI) rates and central line utilization exceeded national benchmarks. Between July 2025 and March 2026, 32 CLABSIs occurred hospital-wide, with a standardized infection ratio (SIR) of 1.35, more than seven times the national target of 0.19. The standardized utilization ratio (SUR) was 0.72 (target: 0.57), while the surgical intensive care unit (SICU) baseline SUR was higher at 1.06.
Aim of the Project: This Doctor of Nursing Practice (DNP) quality improvement (QI) project used an evidence-based central line checklist from the Agency for Healthcare Research and Quality (AHRQ) to improve the timely identification and removal of unnecessary central lines in a 16-bed SICU. Goals were 100% completion of eligible checklist assessments and 100% removal of identified unnecessary lines before ICU transfer.
Review of the Evidence: Sixteen peer-reviewed studies supported process standardization, interdisciplinary collaboration, and leadership engagement as key strategies for reducing unnecessary central line use and CLABSI risk.
Project Design: Three Plan-Do-Study-Act (PDSA) cycles and the OhioHealth Change Management Model guided implementation and staff adoption.
Intervention: Over the 9-week implementation period, the interdisciplinary team completed checklist assessments of central line necessity, registered nurses cross-checked identified lines each shift, and nursing leadership conducted daily audits.
Significant Findings/Outcomes: All 303 eligible checklist assessments were completed, and all 23 identified unnecessary central lines were removed before ICU transfer. The SICU SUR decreased 10.4% during implementation, from a baseline of 1.06 to 0.95. One CLABSI occurred in week 4, and none occurred in the remaining 5 weeks. No lines were reinserted within 24 hours of removal.
Implications for Nursing: Building a standardized line necessity check into existing nursing workflows supported consistent, timely removal of unnecessary central lines before ICU transfer. Ongoing leadership oversight and auditing are recommended to sustain results.
Recommended Citation
Cunningham, Lakeesha, "Improving Patient Safety Through Daily Evaluation of Central Line Necessity" (2026). All Doctor of Nursing Practice (DNP) Scholarly Projects. 84.
https://fuse.franklin.edu/dnp-project/84
Rights
Copyright, all rights reserved
Included in
Critical Care Commons, Critical Care Nursing Commons, Infectious Disease Commons, Nursing Administration Commons, Other Nursing Commons, Quality Improvement Commons
