Central lines, indwelling urinary catheters, and other invasive devices can be life‑saving when used appropriately. However, without meticulous insertion and maintenance practices, these same devices can increase the risk of serious infection. To prevent this, healthcare organizations rely on evidence‑based bundles—sets of proven strategies grouped together to reduce complications associated with device use and other clinical procedures.
Why Bundle Compliance Matters
To ensure these bundles are used effectively, teams routinely conduct audits that evaluate whether each bundle element is met. These findings produce an overall compliance score. The higher the compliance, the lower the infection risk; conversely, low compliance signals an opportunity for improvement.
But the real question is: What do we do with that information?
There are two important steps:
- Provide immediate, individualized feedback to the nurse or clinician about any missed elements.
- Aggregate and share the data in a meaningful way with the broader clinical team so performance trends can be recognized and addressed.
This is where feedback becomes essential.
Effective Feedback: What It Looks Like
Feedback can come from unit leadership, audit teams, or infection prevention specialists. Regardless of who delivers it, effective feedback should be:
- Timely – provided as close to the observed event as possible.
- Individualized and customizable – relevant to the specific practice gaps or strengths.
- Non‑punitive – focused on improvement, not blame.
- Actionable – offering clear guidance to support behavior change.
Feedback may be shared electronically, face‑to‑face, or in writing. Engaging the recipient—allowing them to ask questions, reflect, and set realistic goals—promotes stronger buy‑in and improves outcomes. When feedback is delivered in real time, staff not only receive immediate correction but can also be recognized for correct practice.
Another impactful strategy is involving healthcare workers in the auditing process itself. This sense of ownership often leads to higher adherence in the future.
From Data to Actionable Insights
Presenting compliance data in a clear, visual format—such as run charts—helps staff see how their efforts influence performance over time. Feedback should highlight:
- A clear target or benchmark
- Easily understood action items
- Opportunities for system‑level and individual improvement
- Positive trends as well as areas for growth
When addressing opportunities, keep the focus on process, not personal shortcomings. And remember: creativity goes a long way. Small touches—such as recognizing units with high compliance or offering candy during real‑time rounding and education—can make feedback feel supportive and motivating rather than corrective.
References
Centers for Disease Control and Prevention. (n.d.). CBT 103: Infection control training presentation. https://www.cdc.gov/infection-control/media/pdfs/Strive-CBT103-508.pdf
Gaughan, A. A., MacEwan, S. R., Gregory, M. E., Eramo, J. L., Rush, L. J., Hebert, C. L., & McAlearney, A. S. (2024). When Infections Are Found: A Qualitative Study Characterizing Best Management Practices for Central Line-Associated Bloodstream Infection and Catheter-Associated Urinary Tract Infection Performance Monitoring and Feedback. Nursing Reports, 14(2), 1058–1066. https://doi.org/10.3390/nursrep14020080
Hill, B., Lamichhane, G., & Wamburu, A. (2024). Infection prevention and control: critical strategies for nursing practice. British Journal of Nursing, 33(17), 804–811. https://doi.org/10.12968/bjon.2024.0286
Reynolds, S. (2020, October 4). Using audit and feedback to improve compliance with evidence-based practices. American Nurse. https://www.myamericannurse.com/using-audit-and-feedback-to-improve-compliance-with-evidence-based-practices/