Enhancing Compliance with Central Venous Catheterization Guidelines: A Quality Improvement Audit in a Teaching Hospital

Introduction: Central venous catheter (CVC) insertion is a critical yet high-risk procedure in medical care. This audit aimed to evaluate and enhance compliance with standardized guidelines for CVC insertion among postgraduate residents at a tertiary care hospital in Rawalpindi, Pakistan, to minimize central line-associated bloodstream infections (CLABSI). Methods: A cross-sectional observational study was conducted in Medical and Nephrology units over two audit cycles spanning seven months. Practices of 34 postgraduate residents were evaluated using a structured checklist based on the guidelines from John Hopkins Medicine and the American Society of Anesthesiologists. A targeted intervention, including educational materials, was introduced post-initial audit, and compliance rates were reassessed through a re-audit. Results: Initial compliance rates with key procedural practices were below satisfactory thresholds (< 80%) in 26.4% of cases, particularly in areas like aseptic techniques and full barrier precautions. Post-intervention, re-audit results demonstrated significant improvements, with 94% of residents achieving adequate compliance scores (> 80%). Improvements were particularly notable in the use of full barrier precautions (47.1–82.3%; p = 0.002) and sterile draping (58.8–85.3%; p = 0.0001). Conclusions: Structured interventions, such as education and checklist-based guidance, significantly enhance compliance with standardized CVC practices. Regular audits and continuous education programs are recommended to sustain these improvements and reduce CLABSI risks in resource-constrained settings.