{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T22:50:46Z","timestamp":1789426246563,"version":"build-2803163510"},"reference-count":26,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,3,24]],"date-time":"2025-03-24T00:00:00Z","timestamp":1742774400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100003395","name":"Shanghai Municipal Education Commission","doi-asserted-by":"publisher","award":["DGF400002"],"award-info":[{"award-number":["DGF400002"]}],"id":[{"id":"10.13039\/501100003395","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003347","name":"Fudan University","doi-asserted-by":"publisher","award":["FNF202201"],"award-info":[{"award-number":["FNF202201"]}],"id":[{"id":"10.13039\/501100003347","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Clinical Nursing"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Aims and Objectives<\/jats:title><jats:p>To investigate evidence\u2010based practices and examine rates of adherence to bundles on maintenance of central venous catheters among intensive care unit nurses in 22 selected hospitals.<\/jats:p><\/jats:sec><jats:sec><jats:title>Background<\/jats:title><jats:p>Although there has been an overwhelming increase in the use of evidence\u2010based practices to reduce Central Line\u2010Associated Bloodstream Infections, also known as bundles, there continues to be a considerable gap between clinical practice and evidence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>This study employs a multi\u2010center cross\u2010sectional design.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Registered nurses who worked in the ICUs of 22 selected hospitals were included. Evidence\u2010based procedures were developed based on Central Line Bundles, which include an 11\u2010area and 35\u2010item checklist. Rates of adherence to bundles were calculated and analysed after reaching 22,000 central line days in 22 units. The study was reported using the STROBE checklist.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The average adherence rate to evidence\u2010based procedures for CVC maintenance among ICU nurses in the 22\u2009units was 87.40%. The adherence rate of five areas of the evidence\u2010based procedure based on the Central Line bundle was above 90%, including \u2018Selection of regulated skin disinfectants\u2019, \u2018Tube sealing\u2019, \u2018Tube flushing\u2019, \u2018Dressing and catheter fixation\u2019 and \u2018Sterilized skin and catheter\u2019. The three lowest\u2010achieving areas of bundles were \u2018Catheter and insertion site assessment,\u2019 \u2018Hand hygiene\u2019 and \u2018Sterilized catheter access hubs\u2019. The lowest\u2010achieving item of bundles is \u2018Assess during multidisciplinary patient care rounds with signature confirmation\u2019. The adherence rates in hospitals where CLABSI occurred were all less than 90%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>ICU nurses' adherence to maintenance bundles for CVC is moderate, implying that boosting adherence rates is critical for improved results. As a result, comparable studies should be done in ICUs where the bundle has been deployed to assess and improve adherence rates through effective interventions. To minimise CLABSI in future practice, novel strategies must be developed and implemented via continued education and regular evaluation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Trial Registration<\/jats:title><jats:p>We registered the trial with the US Clinical Trials Registry (ID: NCT06085690, Name: Multicenter Clinical Translational Study of \u2018ICU\u2010NO CRBSI\u2019 Based on Improvement Science, <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/ichgcp.net\/clinical-trials-registry\/NCT06085690\">https:\/\/ichgcp.net\/clinical\u2010trials\u2010registry\/NCT06085690<\/jats:ext-link>)<\/jats:p><\/jats:sec><jats:sec><jats:title>Implications for patient care<\/jats:title><jats:p>Nurse administrators and policymakers can develop strategies and interventions for improving the quality of CVC care toward evidence\u2010based practice. Minimising the gaps between evidence and practice will reduce the incidence of CLABSI to enhance the survival of critically ill patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Impact<\/jats:title><jats:p>In addressing the status of evidence\u2010based practices among ICU nurses, this study enhances healthcare quality and outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patient or Public Contribution<\/jats:title><jats:p>There was no patient or public contribution.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jocn.17692","type":"journal-article","created":{"date-parts":[[2025,3,25]],"date-time":"2025-03-25T01:04:58Z","timestamp":1742864698000},"page":"4351-4365","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Evidence\u2010Based Practice in Maintenance of Central Venous Catheters Among Intensive Care Unit Nurses: A Cross\u2010Sectional Multi\u2010Center Study"],"prefix":"10.1111","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6630-3053","authenticated-orcid":false,"given":"Tianjun","family":"Zhou","sequence":"first","affiliation":[{"name":"School of Nursing Fudan University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunlei","family":"Li","sequence":"additional","affiliation":[{"name":"School of Nursing Fudan University  Shanghai China"},{"name":"Zhongshan Hospital  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhe","family":"Wang","sequence":"additional","affiliation":[{"name":"School of Nursing Fudan University  Shanghai China"},{"name":"Zhongshan Hospital  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mayi","family":"Yang","sequence":"additional","affiliation":[{"name":"School of Nursing Fudan University  Shanghai China"},{"name":"Minhang Hospital  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaofeng","family":"He","sequence":"additional","affiliation":[{"name":"School of Nursing Fudan University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7066-3393","authenticated-orcid":false,"given":"Yan","family":"Hu","sequence":"additional","affiliation":[{"name":"School of Nursing Fudan University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,3,24]]},"reference":[{"issue":"3","key":"e_1_2_12_2_1","doi-asserted-by":"crossref","first-page":"302","DOI":"10.2991\/jegh.k.210524.001","article-title":"Epidemiology and Microbiological Profile of Common Healthcare Associated Infections Among Patients in the Intensive Care Unit of a General Hospital in Kuwait: A Retrospective Observational Study","volume":"11","author":"Alfouzan W.","year":"2021","journal-title":"Journal of Epidemiology and Global Health"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-021-06243-z"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1155\/2018\/4658181"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000142399.70913.2F"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciu239"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13012-015-0306-1"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.4103\/0019-5049.126785"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2014.11.014"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.5694\/mja15.00440"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-018-3514-x"},{"issue":"8","key":"e_1_2_12_12_1","article-title":"Prevention of Central Line\u2010Associated Bloodstream Infections Through Educational Interventions in Adult Intensive Care Units: A Systematic Review","volume":"13","author":"Foka M.","year":"2021","journal-title":"Cureus"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13012-019-0910-6"},{"key":"e_1_2_12_14_1","volume-title":"Australian Guidelines for the Prevention and Control of Infection in Healthcare","author":"Health I.","year":"2019"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(15)00409-0"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/JHQ.0000000000000164"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.11124\/01938924-201513080-00006"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jiac.2014.10.010"},{"key":"e_1_2_12_19_1","unstructured":"Nikolopoulou K.2022.\u201cWhat Is the Hawthorne Effect? | Definition & Examples. 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