Using a checklist to identify barriers to compliance with evidence-based guidelines for central line management: A mixed methods study in Mongolia

Ider, Bat-Erdene, Adams, Jon, Morton, Anthony, Whitby, Michael, Muugolog, Tsolmon, Lundeg, Ganbold and Clements, Archie (2012) Using a checklist to identify barriers to compliance with evidence-based guidelines for central line management: A mixed methods study in Mongolia. International Journal of Infectious Diseases, 16 7: E551-E557. doi:10.1016/j.ijid.2012.03.006

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Author Ider, Bat-Erdene
Adams, Jon
Morton, Anthony
Whitby, Michael
Muugolog, Tsolmon
Lundeg, Ganbold
Clements, Archie
Title Using a checklist to identify barriers to compliance with evidence-based guidelines for central line management: A mixed methods study in Mongolia
Journal name International Journal of Infectious Diseases   Check publisher's open access policy
ISSN 1201-9712
1878-3511
Publication date 2012-07
Sub-type Article (original research)
DOI 10.1016/j.ijid.2012.03.006
Open Access Status DOI
Volume 16
Issue 7
Start page E551
End page E557
Total pages 7
Place of publication Oxford, United Kingdom
Publisher Elsevier
Collection year 2013
Language eng
Formatted abstract
Objectives: This study aimed to determine the extent to which a checklist has potential for identifying barriers to compliance with central line management guidelines, to evaluate the potential utility of checklists to improve the management of central lines in Mongolia, and to define the gap between current and best practices.

Methods: A 22-item checklist was developed based on the Centers for Disease Control and Prevention (CDC, USA) guidelines and existing central line-associated bloodstream infection (CLABSI) checklists. The checklist was used to observe 375 central line procedures performed in the intensive care units of four tertiary hospitals of Mongolia between July and December 2010. In parallel, 36 face-to-face interviews were conducted in six other tertiary hospitals to explain practice variations and identify barriers.

Results: The baseline compliance level across all components of the checklist was 68.5%. The main factors explaining low levels of compliance were outdated local standards, a lack of updated guidelines, poor control over compliance with existing clinical guidelines, poor supply of medical consumables, and insufficient knowledge of contemporary infection control measures among health care providers.

Conclusions: The health authorities of Mongolia need to adequately address the prevention and control of CLABSIs in their hospitals. Updating local standards and guidelines and implementing adequate multifaceted interventions with behavioral, educational, and logistical components are required. Use of a checklist as a baseline evaluation tool was feasible. It described current practice, showed areas that need urgent attention, and provided important information needed for future planning of CLABSI interventions.
Keyword Infection control
Central line-associated bloodstream infection
Checklist
Central venous catheters
Intensive care unit
Mongolia
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2013 Collection
School of Public Health Publications
School of Medicine Publications
 
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