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Barriers to Nurses’ Adherence to Central Venous Catheter Guidelines

Jeffery, Alvin D. MSN, RN-BC, CCRN, FNP-BC; Pickler, Rita H. PhD, RN, PPCNP-BC, FAAN

JONA: The Journal of Nursing Administration: July/August 2014 - Volume 44 - Issue 7/8 - p 429–435
doi: 10.1097/NNA.0000000000000094

OBJECTIVE: The aim of this study was to explore nurses’ perceived barriers to adherence of standard central venous catheter (CVC) care practices.

BACKGROUND: Although CVC care practices are evidence based, adherence to practices may not always occur, contributing to nosocomial infections. Previous practice adherence studies focused primarily on systems improvement or observational methods. This pilot study explored nurses’ perceptions of barriers to practice adherence.

METHODS: A descriptive phenomenological method involving 10 participants was used. Data were collected through interviews and analyzed with Colaizzi’s method.

RESULTS: Data were grouped into major themes: cognitive factors (active and passive thinking processes) and contextual factors (patient condition along with materials, processes, and culture of the organization). Three connecting subthemes were identified.

CONCLUSION: Adherence barriers have potential to produce errors and may limit nurses from providing high-quality care. Interventions to reduce barriers are needed, particularly those focused on resource availability and designing more intuitive processes.

Author Affiliations: Education Consultant (Mr Jeffery) and Professor, Nurse Scientist, and Scientific Director for Nursing (Dr Pickler); Center for Professional Excellence, Cincinnati Children’s Hospital Medical Center, Ohio.

The study was supported in part by a Carolyn Stoll Award from the Department of Patient Services, Cincinnati Children’s Hospital Medical Center.

The authors declare no conflicts of interest.

Correspondence: Mr Jeffery, 3333 Burnet Ave, MLC 8006, Cincinnati, OH 45229 (

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins