Bundle-Based Nursing Interventions for CLABSI Prevention in Saudi Government Hospitals: A Meta-Analysis of Compliance and Infection Outcomes Across Indexed Studies (September 2015–September 2025)
Description
Background: Central Line-Associated Bloodstream Infections (CLABSIs) are among the most preventable yet persistent healthcare-associated infections in intensive care units (ICUs). In Saudi Arabia, government hospitals have increasingly adopted bundle-based nursing protocols to mitigate CLABSI risks. This meta-analysis evaluates the effectiveness of nursing-led interventions in reducing CLABSI incidence and improving compliance across public-sector ICUs. Methods: A systematic search of indexed databases—including PubMed, Scopus, and the Saudi Digital Library—was conducted to identify peer-reviewed studies published between September 2015 and September 2025. Inclusion criteria focused on studies conducted exclusively in Ministry of Health, military, and university-affiliated hospitals. Eligible studies reported on nursing compliance with CLABSI prevention bundles and associated infection outcomes. Data were extracted using a standardized matrix and analyzed using a random-effects model to account for institutional variability. Results: Fifteen studies met inclusion criteria, encompassing 1,842 ICU patients across seven regions. Bundle components consistently included hand hygiene, maximal barrier precautions, chlorhexidine skin antisepsis, and daily line necessity review. Pooled analysis revealed a significant reduction in CLABSI rates (RR = 0.41, 95% CI: 0.30–0.55) in units with high nursing compliance (>80%). Facilities with structured audits, electronic surveillance, and continuous nurse education demonstrated the most substantial improvements. Moderate heterogeneity (I² = 46%) reflected differences in staffing ratios, training intensity, and bundle fidelity. Conclusion: Nursing-led implementation of CLABSI prevention bundles in Saudi government hospitals is strongly associated with reduced infection rates. High compliance, supported by institutional oversight and standardized protocols, is essential to sustaining outcomes. These findings reinforce the need for national policy alignment, continuous nurse training, and robust surveillance systems to optimize infection control across public-sector ICUs.
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Institutions
- Lyceum-Northwestern University
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Funders
- None