Nursing in critical care
Reducing Central Line-Associated Bloodstream Infections in ICUs: A Systematic Review of Barriers and Facilitators and Intervention Measures
By Shi H, Huang J, Gu K and 1 others.
Abstract
Background
Despite established guidelines, central line-associated bloodstream infection (CLABSI) remains a severe ICU complication due to cognitive and resource barriers hindering healthcare worker compliance. A systematic evaluation of these barriers and facilitators is currently lacking but is important for informing targeted implementation strategies for CLABSI prevention.
Aims
To explore the barriers and facilitators to implementing CLABSI prevention in ICUs using the Consolidated Framework for Implementation Research (CFIR) to provide evidence-based strategies for improvement.
Study design
A PRISMA-guided systematic review was performed using PubMed, Embase, CINAHL, Web of Science, Cochrane Library, CNKI, VIP, Wan fang, and CBM databases, up to August 2026. Eligible studies included qualitative, quantitative, or mixed-methods research on the barriers and facilitators to CLABSI prevention implementation among ICU healthcare workers. Two researchers independently screened studies, extracted data, and assessed quality using the Mixed Methods Appraisal Tool (MMAT). Data synthesis and intervention development were guided by the CFIR, with targeted strategies mapped using the CFIR-ERIC (Expert Recommendations for Implementing Change) matching tool.