Digital Repository Masters Theses Spring 2026 Improving Central Line Discharge Education to Address Pediatric Nurse Comfort Lindsey Marie Wood Weber State University Follow this and additional works at: https://dc.weber.edu/collection/wsudoctoral Wood, L. 2026. Improving Central Line Discharge Education to Address Pediatric Nurse Comfort. Weber State University Doctoral Projects. https://cdm.weber.edu/digital/collection/WSUDoctoral This Project is brought to you for free and open access by the Weber State University Archives Digital Repository. For more information, please contact archives@weber.edu. WSU REPOSITORY MSN/DNP Supporting Bedside Nurses in Providing Patient Education for CVC Discharge Teaching Project Title by Lindsey Wood Student’s Name A project submitted in partial fulfillment of the requirements for the degree of MASTERS OF NURSING Annie Taylor Dee School of Nursing Dumke College of Health Professions WEBER STATE UNIVERSITY Ogden, UT 04/19/2026 Date Lindsey Wood, RN, BSN, CPN 04/16/2026 Student Name, Credentials (electronic signature) Date Anne Kendrick, DNP, RN, CNE 04/25/2026 MSN Project Faculty Date (electronic signature) Anne Kendrick, DNP, RN, CNE 04/25/2026 Anne Kendrick Date (electronic signature) DNP, RN, CNE MSN Program Director Note: The program director must submit this form and paper. 1 Improving Central Line Discharge Education to Address Pediatric Nurse Comfort Lindsey Marie Wood Annie Taylor Dee School of Nursing Master of Science in Education Weber State University Dr. Anne Kendrick MSN Project April 25, 2026 2 Abstract Purposes/Aims: Design an improved central venous catheter (CVC), also known as a central line, discharge education process that supports pediatric bedside nurses in delivering quality patient education. Rationale/Background: Bedside nurses face many challenges when providing patient education. CVC discharge education is complex, and poor education may contribute to CVCassociated complications. Many pediatric nurses express feeling uncomfortable delivering this education. Implementing best-practice methods outlined in the literature may help alleviate the challenges nurses face and improve their comfort. Methods: Using the Model for Improvement as the framework, teaching resources and a nurse training presentation for CVC discharge education were developed, with a detailed implementation plan. To assess the impact of these changes on nurse comfort, pre- and postimplementation surveys for bedside nurses were designed to quantitatively compare comfort levels. Results: Nurse comfort in providing CVC discharge education may improve by implementing evidence-based education principles. Several studies and publications have improved the quality of pediatric CVC home care education by optimizing timing, using teaching tools and resources to support learning, and providing nurse training on delivering education. Conclusions: Using evidence-based interventions to support patient education can benefit bedside nurses by helping them feel comfortable and capable in teaching complex concepts such as CVC home care. The potential insights from this project can be applied across all areas of patient education. Keywords: central venous catheter, central line, central line-associated bloodstream infection, parent/caregiver 3 Improving Central Line Discharge Education to Address Pediatric Nurse Comfort A central line, or central venous catheter (CVC), is a medical device that allows longand short-term intravenous therapy. The use of CVCs in the home setting is becoming increasingly common in pediatric healthcare (National Home Infusion Association, n.d.). This reduces patients' time in the hospital and allows specific treatments to be completed more comfortably at home or in an outpatient setting. However, many complications are associated with CVCs if not cared for properly, with one of the most serious complications being a central line-associated bloodstream infection or CLABSI (Ullman & Chopra, 2025). Previously, healthcare providers were responsible for preventing these infections (Centers for Disease Control and Prevention, 2025); however, as this responsibility shifts to patients and parents in the pediatric home setting, quality education is essential. Unfortunately, bedside nurses, who are primarily responsible for providing this education (Foucault-Fruchard et al., 2025), face numerous challenges and often lack confidence in their ability to prepare parents to care for their child’s CVC at home. Statement of Problem Pediatric nurses must provide thorough education at the bedside to prepare parents and caregivers who are discharging from the hospital to care for a child with a CVC at home. However, in general, there is no standard for this education or training, and resources to support bedside nurses in providing CVC teaching are often limited (United Hospital Fund, 2017). Bedside nurses also face several barriers to patient education, including time constraints and high patient workloads (Longhini et al., 2025; Pueyo-Garrigues et al., 2022). Due to these barriers and 4 limitations, nurses often feel uncomfortable providing CVC discharge education, and many do not feel competent in preparing patients and families to care for their CVC. To underscore the seriousness of this problem, a study by Rinke et al. (2013) estimated that CLABSIs acquired at home are three times as common as those acquired in the hospital setting among pediatric oncology patients. Since CLABSIs are preventable with proper care (Centers for Disease Control and Prevention, 2024), this suggests that parents/caregivers are not receiving adequate education. Fortunately, studies have shown that patients are less likely to experience these complications at home with improved education processes (Foucault-Fruchard et al., 2025). Significance of the Project Discharge education of all types is challenging for bedside nurses (Luther et al., 2019; Longhini et al., 2025; St. John & Englund, 2020). Nurses face time constraints, insufficient training, skill deficits, limited resources, and high patient workloads, all of which make it challenging to deliver high-quality patient education (Longhini et al., 2024; Pueyo-Garrigues et al., 2022). The CVC discharge process is no different, but it has a higher risk of complications. An improved CVC discharge education process is necessary to support nurses in delivering highquality education. Review of the Literature This literature review explores current quality practices in patient discharge education for CVCs and the barriers faced by bedside nurses. The following question guided this literature review to identify specific interventions for best-practice discharge education: In pediatric nurses discharging patients with a CVC, does using best-practice discharge education, compared to current practice, affect their comfort in providing discharge education for CVCs? 5 This review highlights specific barriers to quality education and provides methods to overcome them, thereby facilitating quality education. Included in the review are studies specific to CVC education, as well as less specific studies that investigate overall quality patient education factors. Framework The Model for Improvement will be used to implement a new process for CVC discharge education. This model begins by asking three questions to develop the practice change (Institute for Healthcare Improvement, n.d.). The first question, “What are we trying to accomplish?”, is the project's purpose: to improve nurse comfort in providing CVC discharge education. This focuses the practice change on supporting bedside nurses. The second question, “How will we know that a change is an improvement?” is addressed through well-designed pre- and postsurveys that assess nurses’ confidence, competence, and comfort when providing CVC discharge education. The final question, “What change can we make that will result in improvement?” is answered based on the findings from the literature review. The second part of the Model for Improvement involves plan-do-study-act (PDSA) cycles (Institute for Healthcare Improvement, n.d.). PDSA worksheets from the Agency for Healthcare Research and Quality will organize these cycles for the practice change. The PDSA process begins by slowly implementing the change on a smaller scale/population and analyzing its effects. This is known as a single cycle and results in identifying areas for improvement prior to the next cycle (Agency for Healthcare Research and Quality, 2018). The PDSA cycles for improving CVC discharge education begin with proposing initial teaching resources and a training presentation for nurses on one hospital unit. After incorporating their feedback, the first cycle will be completed. This hospital unit will then practice using 6 concepts from the training and the teaching resources. Feedback from this experience will be obtained to direct further improvements. The cycles will continue until the resources and training are refined and hopefully prove effective in supporting bedside nurses. The hospital-wide implementation will also undergo its own PDSA cycle through reflection, using pre- and postimplementation surveys to identify areas for improvement and plan changes for further implementation. Strengths and Limitations The overall strengths of using the Model for Improvement are that it is straightforward, with easy-to-follow steps, and allows for a clear vision of the practice change. Additionally, incorporating PDSA cycles provides opportunities to refine the process change, thereby increasing the chances of successful integration (Reed et al., 2016). The Model for Improvement also uses objective process or outcome measures to evaluate impact (New York State Department of Health, n.d.). A limitation to using this method is that the initial questions driving the practice change are answered subjectively. In this project, however, the answer to “What change will result in improvement?” is based on the findings from the literature review. Although this model alone may not be sufficient evidence or scientifically based for identifying the practice change, the research related to this project applied evidence-based findings to identify specific interventions. Search Strategies A literature search was conducted to identify current evidence using Google Scholar, Weber State University’s Stewart Library’s OneSearch database, and Intermountain Health’s Library Services database. Originally, only articles published in the last six years were included to ensure findings are relevant and up to date. However, several articles cited the findings by 7 Rinke et al. (2013), and so this older work was included, along with two additional relevant sources. Key words and phrases used for the search include: “pediatric” AND “central line” OR “central venous catheter” AND “discharge education” OR “home care education” OR “hospital discharge education”. Other search phrases include: “patient discharge education” AND “supporting bedside nurses” OR “barriers to quality patient education” OR “nurse comfort” AND “nurse competency”. A combination of the above terms was used to conduct a broad search relevant to the topic. Synthesis of the Literature Several themes emerged from the literature. The first theme identified recurrent challenges and barriers that bedside nurses face when providing patient education. The second theme synthesized common approaches from the literature to improve patient education. Then, the final theme established a connection between CVC education improvement and improved patient outcomes. Challenges and Barriers for Bedside Nurses Providing Patient Education Bedside nurses are identified as primarily responsible for providing patient discharge education and overall health education (Luther et al., 2019; Pueyo-Garrigues et al., 2022; St. John & England, 2020). The literature identifies several potential factors limiting bedside nurses’ ability to provide quality patient education and discharge education. Factors include time constraints, heavy workloads, prioritizing clinical tasks over patient education, a lack of nurse training to provide education or acquire pedagogical skills, and limited access to educational resources and tools (Longhini et al., 2025; Pueyo-Garrigues et al., 2022; St. John & England, 2020). 8 Methods To Improve the Quality of Patient Discharge Education Much of the literature aims to improve the quality of patient education through various methods. Recurring educational interventions are consistently observed across multiple studies. These interventions can be categorized under the following topics: optimizing education timing, utilizing teaching tools and resources, and providing staff training in education. Optimizing Education Timing. One recurring sub-theme for improving patient education involved the timing of education delivery. Several studies have recognized that education quality improves when it is started early and repeated over time (Foucault-Fruchard et al., 2025; Keller et al., 2024; Longhini et al., 2025). Several studies from a systematic review reported various education timing interventions used to improve patient CVC education (Foucault-Fruchard et al., 2025). One study conducted two to three didactic sessions; another provided a total of four hours of education over three days; and another study conducted seven to ten educational sessions, with a limit of one session per day. Other studies similarly avoid information overload by spacing out learning sessions and limiting the amount of information per learning session (Foucault-Fruchard et al., 2025; Keller et al., 2024; Luther et al., 2019). Nurse managers from another study also report that waiting until discharge to perform education can be ineffective (Longhini et al., 2025). Utilizing Teaching Tools & Resources. A second sub-theme in the literature is the use and creation of multimodal education tools to structure patient education and support learning. Multiple studies from a systematic review used visual aids, tools, and videos to improve patient education (Foucault-Fruchard et al., 2025). Nurse managers also recognize the value of “checklists, charts, and brochures,” as well as more patient education handouts (Longhini et al., 2025). Bailie et al. (2021) analyzed caregiver perspectives on CVC education and found that a 9 visual booklet alone was insufficient to support learning. Therefore, skill videos were created and added to the booklet using QR codes. The United Hospital Fund (2017) surveyed home health nurses and identified a need for evidence-based resources for CVC home care. Consequently, funding was used to create a visual guideline booklet for line CVC education. Two additional studies incorporated laminated visuals for CVC skills; Keller et al. (2024) created a saline-antibiotic-saline mat to assist with medication administration, and Beauchamp-Walers et al. (2024) created a laminated visual map for CVC dressing changes. Providing Staff Training in Education. Another topic of focus in the literature is improving the quality of patient education by training staff in health education and pedagogical skills. One study employed the “train the nurse trainer” approach as an intervention to enhance educational quality (Wong et al., 2024). In another study, caregivers identified inconsistencies in CVC education provided by individual nurses, which made the education confusing. To alleviate this, training videos about how to provide education were created for nurses (Bailie et al., 2021). Another study analyzed nurse managers' perspectives and identified courses to train nurses in education practices as an area to support quality patient discharge education (Longhini et al., 2025). One study analyzing education competency found that bedside nurses reported low scores for pedagogical skills, such as the teaching-learning process. These nurses also reported a lack of health education and training as the main barrier to providing patient education (Pueyo-Garrigues et al., 2022). Effects of Educational Improvements Applied to Central Line Discharge Education Overall, studies that focused on improving CVC discharge education led to better patient outcomes. The primary outcome measure involves reducing CLABSIs acquired in the home setting; however, other patient outcomes, such as parent/caregiver satisfaction, were also 10 improved in some studies (Foucault-Fruchard et al., 2025). Bailie et al. (2021) reported high parent satisfaction, specifically with the skill videos. Altounji et al. (2020) reported a decrease in mucosal-barrier central venous catheter-associated infections after the education revision. Several other studies have significantly reduced CLABSI rates after implementing improved education for parents/caregivers (Beauchamp-Walters et al., 2024; Foucault-Fruchard et al., 2025; Wong et al., 2024). Summary of Literature Review Findings and Application to the Project The literature review examines the challenges that bedside nurses face in delivering patient education and presents successful strategies to overcome these barriers, which can be applied to CVC discharge education. Some barriers, such as prioritizing clinical tasks over education and heavy workloads, are not addressed in this literature review. However, common methods to improve patient education include optimizing education timing, training staff to deliver CVC discharge education, and creating teaching tools and resources for both patients and nurses. When applied to CVC education, these improvements have been shown to positively affect patient outcomes. Project Plan and Implementation Based on the findings of the literature review, best-practice CVC discharge education changes for this project include implementing the following teaching resources for both parents and bedside nurses: an education timeline to distribute learning, a visual education booklet, and video skill demonstrations to reference during and after teaching. Additionally, nurses should be trained to deliver CVC discharge education. The goal of this project is to support pediatric bedside nurses in providing CVC discharge education. 11 Project Plan and Implementation Process Initially, the education timeline, visual education booklet, and skill videos will be developed and refined using PDSA cycles. Once the educational tools and resources are finalized, they will be incorporated into a presentation to educate bedside nurses on how to provide CVC discharge education. This training presentation will also undergo a PDSA cycle, which will be repeated until the feedback indicates that it supports bedside nurses in learning to provide CVC discharge education and in utilizing the new teaching resources. The next step is delivering the training presentation to the bedside nurses at each unit’s upcoming staff meeting. Only the following units, which regularly provide CVC discharge education, will be included: the inpatient cancer services unit, the children’s medical surgical unit, the neonatal intensive care unit, and the neurotrauma unit. The go-live date for the practice change will be announced after the staff meetings. A recording of the training presentation, along with the teaching resources, will be available on the hospital’s website. Nurses will receive notification of the practice change via email and flyer postings. A pre-practice change survey regarding nurse comfort in providing CVC discharge education will be emailed to the units before the staff meetings. Data will be collected through this survey and compared with post-practice change surveys. Included in the surveys are questions to assess comfort and confidence in providing CVC discharge education, as well as questions about the usability of the teaching resources and relevance of the nurse training. Additional changes will be made based on this feedback using a PDSA cycle. The training will be incorporated into onboarding for new bedside nurses, and nurse competency will be monitored. 12 Interdisciplinary Team Several healthcare professionals will be involved in this practice change to improve the CVC discharge education process. There are several aspects to this project, including developing the teaching resources, developing and providing the nurse training presentation, ensuring electronic access to the resources/training, and monitoring the data/impact of the practice change. The interdisciplinary team will include the project lead, unit managers, unit nurse educators, the pediatric hospital’s education team and nurse research team, the hospital’s Pediatric Practice Council, and, most importantly, participation and engagement from the bedside nurses. Developing CVC Teaching Resources. Each unit involved in the CVC discharge education improvement has a nurse educator. Each educator will meet with the team lead to provide input on developing the skill demonstration videos and visual booklet, as well as on designing the CVC discharge education timeline. The team lead will develop a rough draft of the resources/training. The hospital’s education team will take the plans/designs from the team lead to create final handouts and videos that will be available on the hospital's website and YouTube channel. Additionally, this step will require approval from the Pediatric Practice Council, which will review the materials to ensure recommendations are current and comply with best practices. These resources will be further refined through a PDSA cycle at the Children’s Surgical Unit. Unit Managers & Nurse Educators. The manager from each participating unit will be responsible for scheduling and coordinating the staff training presentation. The unit manager will also be responsible for posting the flyers and ensuring that bedside nurses are informed about the upcoming practice change. The nurse educators will deliver the initial training presentation at the staff meeting. The educators will then train newly hired nurses and monitor competency for previously trained nurses in their unit. 13 Hospital Education Team. The education team will assist in designing and embedding the electronic resources needed for this project. A CVC discharge education page will be added to the hospital’s website as a resource for bedside nurses. This team will also be responsible for editing and uploading the skill demonstration videos, which will be available to patients and nurses. Hospital Research Team. The nursing research team will review the design of the preand post-surveys for bedside nurses created by the team lead. This team will be responsible for collecting and reporting data on nurses’ comfort and utilization of the teaching resources and training. The research team will communicate the results of the data to the Pediatric Practice Council. Pediatric Practice Council. The Pediatric Practice Council will review the project's goals and the data results during monthly meetings. Any changes or concerns will be discussed with the unit leaders present at the meeting. Additionally, the Pediatric Practice Council will approve or deny teaching resources and nurse training in accordance with best-practice recommendations. Bedside Nurses. Bedside nurses will be primarily responsible for implementing this project. They will be needed to conduct PDSA cycles to develop the staff training presentation and teaching resources. They will be responsible for learning how to provide CVC discharge education using the new training and resources. Bedside nurses are also needed to monitor the project outcomes by participating in the data collection surveys. Description and Development of Project Deliverables Project deliverables are provided in the appendices, including a teaching resource, a hospital factsheet to inform others about the project, PowerPoint slides for the training 14 presentation, and pre- and post-survey drafts for data collection. The teaching tool example, known as the Journey Home Board, breaks up learning sessions, guides teaching concepts, and provides a visual checklist before discharge. The informational hospital factsheet then prepares bedside nurses for the project plan and upcoming changes. The training presentation is designed to engage bedside nurses in using the teaching resources and provide knowledge about quality education considerations from the literature review. Finally, the pre- and post-surveys were carefully worded to collect data on nurse comfort before the CVC discharge education changes and to compare this comfort level after the practice changes are implemented in this project. The Journey Home Board. The Journey Home Board serves as a teaching resource, a timeline, and a checklist for CVC discharge education (see Appendix A). It was designed to be used together by parents and bedside nurses to guide CVC discharge education. Each box contains an essential concept or skill that parents/caregivers need to learn before discharge, and it is mapped in a logical learning progression. Each learning session provided by the bedside nurse should cover no more than eight boxes/concepts at a time to prevent information overload. This tool supports the theme of optimizing educational timing by spacing out learning sessions, a method identified in the literature as potentially improving CVC discharge education (FoucaultFruchard et al., 2025; Keller et al., 2024; Luther, 2019). The Journey Home Board also serves as a visual teaching tool/checklist, another method mentioned in the literature that may improve the quality of CVC discharge education (Foucault-Fruchard et al., 2025; Longhini et al., 2025). Practice Change Hospital Fact Sheet. The next project example is a hospital factsheet for bedside nurses to prepare them about the new CVC discharge education resources and upcoming training presentation (see Appendix B). Much of this project depends on bedside nurses, and to implement changes to CVC discharge education, they need to be well-prepared 15 and informed. This quick factsheet provides a snapshot of the changes. It will be sent out and posted around the hospital to help nurses buy into the project and be made aware of upcoming training/changes. Training Presentation for Bedside Nurses. The third example is a PowerPoint presentation designed to educate bedside nurses about providing high-quality CVC discharge education (see Appendix C). Per the literature, one approach to improving CVC discharge teaching is to educate and train those who deliver it (Bailie et al., 2021; Wong et al., 2024). This presentation begins by highlighting the reduction in home-acquired CLABSIs resulting from improved CVC discharge education. This is to motivate bedside nurses to adopt the practice change. The presentation also provides information about the challenges they face as bedside nurses in providing quality education and sets the goal to support them in overcoming these challenges. From there, the presentation focuses on considerations from the literature that help achieve high-quality CVC discharge education, such as optimized timing, multimodal educational tools, and consistency. The tools and resources to support their teaching are also explained, including skill videos, a visual booklet, and the Journey Home Board. Pre-Implementation Survey. The pre-survey was designed for pediatric bedside nurses responsible for CVC discharge teaching (see Appendix D). The questions were designed to collect quantitative data to assess nurses' comfort and confidence in performing this patient education. The survey also incorporates years of experience as a demographic that may influence responses. Post-Implementation Survey. The post-survey was designed for pediatric bedside nurses who have gained experience using the new teaching resources and have received the CVC discharge education training presentation (see Appendix D). The first five questions are identical 16 to the pre-implementation survey to compare nurse comfort and confidence in performing this patient education post-implementation. The survey also incorporates questions to assess usability and satisfaction with the new CVC discharge resources and training. Timeline The project's initial implementation is estimated to take nine months and is divided into five phases (see Appendix E). The first three months will be the development phase, during which the resources, training, and webpage are finalized. The next two months will be spent on the preparation phase, training, and preparing the bedside nurses. The next phase will be go-live, where the new CVC discharge education resources will be implemented with support. After the go-live period, the reflection phase involves analyzing post-survey data to assess the project’s success and, as necessary, making changes through a final PDSA cycle. Assuming the project’s success, the next phase will be continuation, which will sustain the project long term. Development. The first phase of the project, development, is estimated to last 3 months. During this phase, focus will be on creating the project's infrastructure. This includes developing/modifying the CVC teaching resources and the nurse training presentation through PDSA cycles. Collaboration meetings between nurse educators/managers, the Practice Change Council, and the project lead will also take place. This phase includes creating a hospital-based webpage for CVC discharge education, where the teaching resources and training presentation will be readily available. Data from the pre-implementation survey will also be gathered. Preparation and Go-Live. The second phase, preparation, is projected to take two months. During this time, email notifications and hospital handouts will be created and distributed. This phase includes providing the training presentation to all bedside nurses and ensuring that managers, nurse educators, and nurses are aware of the new educational resources, 17 including how to use them and where to find them. A go-live date will be announced once each unit has completed the training presentation. In the two months after go-live, nurses will become accustomed to the new CVC discharge education. Educators, managers, and the project lead will maintain an active role in addressing problems and concerns that arise. Reflection and Continuation. After successful project implementation, data will be collected through post-implementation surveys to promote reflection and identify areas for project improvement. This is the large-scale PDSA for the project. The team lead will conduct meetings with the nurse educators/managers to discuss necessary changes or improvements to the project. Assuming success and improved nurse comfort in providing CVC discharge education, the project will advance to the continuation phase after completion of the final PDSA. The continuation phase will include new-hire training and competency monitoring to sustain the project initiatives. Overall, the timeline for this project involves creating and refining the resources and training, announcing and preparing for the change, supporting early implementation, reflecting on the project’s outcomes and making improvements, and then taking steps to ensure the practice change is sustained. This will be achieved through the following phases: development, preparation, go-live, reflection, and continuation. Completing these phases through to the continuation is projected to take nine months, but may take longer if changes or additional PDSA cycles are needed to achieve the project’s goal. Project Evaluation The goal is to improve nurses' comfort with performing CVC discharge teaching. The evaluation for this goal aligns with the Model for Improvement and addresses “How will we know that the change is an improvement?” To assess this, the pre-implementation survey uses a 18 Likert scale, allowing responses on feelings of comfort/competency to be converted into quantitative data. These scores will then be compared to the post-implementation survey results and analyzed for statistical significance. An improved post-implementation score suggests that nurses feel more confident and that the project has improved their ability to provide quality CVC patient education to parents and caregivers. There are, however, other areas of the project that must be considered. For example, the usability of resources and training. The reasons nurses choose to use the teaching resources or not need to be evaluated. Usability questions were added to the post-implementation survey, including a free-response question that allows for clarification or suggestions to help identify any barriers that need to be addressed. Ethical Considerations Ethical considerations for this project include protecting nurses from disciplinary action for their feedback or reluctance to participate, ensuring nurses' feedback remains anonymous, ensuring that patients receive best-practice CVC discharge education despite potential disruptions caused by the changes, and reporting unbiased results. To address anonymous feedback, the pre- and post-implementation surveys will not record identifiable information. During the go-live period, there may be confusion on how to use the new resources/training. If this occurs, the nurses are to provide CVC discharge teaching to the best of their ability, with or without the new changes, to reduce compromising patient education. As for potential bias, there are no conflicts of interest or financial gains associated with this project's results. A positive association between nurses' comfort and the implementation of this project will only influence the continuation of the project; if little or no change occurs, the project will be reassessed to identify better methods for improvement. 19 Discussion This project aims to improve nurse comfort, specifically by providing CVC discharge education, but its key insights can be applied to other areas of nursing patient education. The relationship between supporting nurses in providing high-quality education and potential improvements in patient outcomes may lead to national recommendations for supporting CVC discharge education. However, there are limitations to the basis of this project regarding the literature on how to best support nurses and improve CVC discharge education. More definitive research in this area is needed. Despite this limitation, disseminating the insights from this project will raise awareness of the major problem that many nurses are not given the training or resources they need to provide complex patient education, and will reinforce the connection that supporting bedside nurses in providing quality patient education likely improves overall patient outcomes. Evidence-Based Solutions for Dissemination According to St. Ambrose University Library (n.d.), there are three main ways to disseminate findings from a nursing project: publication, poster presentations, and podium presentations. Since this project is part of Weber State University’s Master of Science in Nursing Education program, a poster presentation was arranged through this institution. This presentation will be shared with peers and faculty. The project will be summarized to succinctly present the key findings from the literature review, how this project may influence nursing, and ideas for further developing and applying the project’s findings. In addition to using the poster presentation, the project can also be shared with the project lead’s current institution and submitted to relevant professional organizations that may find interest and offer support for 20 further dissemination. One potential organization is the Children’s Hospitals Association, which advocates for quality pediatric healthcare nationwide (Children’s Hospitals Association, n.d.). Significance to the Advancement of Nursing Practice The significance of this project is two-fold: its overall impact on improving nursing patient education standards, and its potential nationwide impact on improving CVC discharge education standards. Informing the healthcare community about the findings from this project may lead to examination and improvement in other areas of patient education. Second, there is recognition that patients and caregivers are likely not receiving adequate education to care for their CVC at home. This may lead to a national movement similar to efforts to reduce CLABSI rates in hospitals, focusing on improving CVC discharge education recommendations and standards. Supporting Nurses to Provide Complex Patient Education The problem this project explores is nurse comfort in providing patient education on CVC discharge preparation, but similar considerations apply to other patient education topics. Patient education is a major goal across all fields of nursing (American Nurses Association, n.d.). Often, nurses are expected to educate patients on any given topic, sometimes without training or resources. The complexity of certain education topics, such as CVC discharge education, makes it difficult to teach. Overall, the more comfortable/prepared the nurse is to provide complex patient education, the more likely they are to provide quality education. Therefore, this project can be applied to improve all areas of patient education in nursing, especially for high-risk or complex topics. The challenges and barriers faced by bedside nurses in providing patient education, as addressed in the project, can be applied to any complex patient education topic. For example, 21 nurses report a lack of training and understanding in providing patient education, along with a lack of tools and resources to support their teaching (Longhini et al., 2025; Pueyo-Garrigues et al., 2022). Recognition of these barriers, along with the project's suggested interventions, can be generalized. Providing training to nurses before expecting them to teach complex topics and providing multimodal teaching tools/resources to support their teaching will hopefully become standard practices to help bedside nurses deliver all types of complex patient education. Influencing National Recommendations for Best Practice CVC Discharge Education Based on the literature review, supporting and preparing nurses to provide complex patient education likely improves patient outcomes. Specifically, improving patient education for CVC home care reduces CLABSI infections (Beauchamp-Walters et al., 2024; FoucaultFruchard et al., 2025; Wong et al., 2024), which, in turn, prevent unnecessary hospitalizations or even deaths (Centers for Disease Control and Prevention, 2025). As information from this project is shared, the inadequacy of nurse preparation/support for the responsibility for CVC discharge education may become apparent. Preventing CLABSI infections in the hospital is a healthcare priority, prompting several process measures and recommendations from national organizations such as The Joint Commission and the Centers for Disease Control and Prevention (Centers for Disease Control and Prevention, 2024; McMullen et al., 2025). As the impact of CVC discharge education on home-acquired CLABSI rates becomes evident, these national organizations may also develop and recommend standards and guidelines for best-practice CVC discharge education. Implications Several of the education challenges identified for bedside nurses in providing patient education are not addressed in this project's interventions. For example, the pressure to prioritize 22 clinical tasks over patient education, high workloads that prevent nurses from spending time on patient education, and distractions and interruptions during bedside education are challenges identified in the literature (Longhini et al., 2025; Pueyo-Garrigues et al., 2022; St. John & England, 2020) that are not addressed. Additionally, the methods used to improve CVC discharge education, though involving recurrent themes from the literature, are not well defined, and their impacts are not well established. The interventions used to improve CVC discharge education include optimizing education timing, distributing learning sessions, training nurses to better provide education, and providing multimodal tools and resources to support teaching, all of which are recurrent themes in the literature (Bailie et al., 2021; Beauchamp-Walers et al., 2024; Foucault-Fruchard et al., 2025; Keller et al., 2024; Wong et al., 2024). However, many studies implemented multiple interventions simultaneously or used the same intervention under different standards, making it difficult to determine which intervention yields the best outcomes or improves learning. Despite these limitations, this project is a start toward establishing a connection between nurses' comfort in providing patient education and the use of the best available education practices. Implementing and evaluating the effects on nurse comfort will highlight how prepared nurses feel to deliver patient education and what pediatric hospitals can do to support them in providing quality patient education. The literature also suggests that improving nurses' comfort in providing complex patient education is likely to improve patient outcomes. Ideally, further studies could explore and confirm this connection. Recommendations The findings from this project should be replicated and applied to other nursing patient education topics, as well as to improve CVC discharge education, thereby stimulating additional 23 projects and research. The additional barriers to patient education not addressed in this project can be addressed in others. More conclusive studies establishing the effects of specific interventions for best-practice CVC discharge education can be designed. Lastly, as greater attention is paid to this problem and more connections are made between improved nurse comfort and patient outcomes, national organizations can develop guidelines and recommendations to support bedside nurses in delivering various patient education topics. Conclusions CVC discharge education is a complex task for bedside pediatric nurses who face many challenges when providing patient education. The literature suggests common themes for improving and providing best practice CVC education for patients and caregivers who must care for these devices in the home setting. These common themes are incorporated into the implementation plan for this project, which includes creating an education timeline, multimodal teaching tools, and a training presentation for bedside nurses. Previous studies have connected these improvements to reduced CVC-associated complications (Foucault-Fruchard et al., 2025), but this project will assess whether these also support bedside nurses by increasing their comfort in providing this education. Overall, the concepts used to improve the quality of CVC discharge education can be applied to other areas of patient education, and the findings from this project may highlight the importance of addressing nurses' comfort when providing specific, complex patient education by implementing best-practice patient education methods. 24 References American Nurses Association. (n.d.). What is nursing? Retrieved February 13, 2026, from https://www.nursingworld.org/practice-policy/workforce/what-is-nursing/ Agency for Healthcare Research and Quality. (2018, November). Worksheet for Plan-Do-Study-Act (PDSA) cycle planning. https://www.ahrq.gov/evidencenow/tools/pdsa-worksheet.htmlLinks to an external site. Altounji, D., McClanahan, R., O’Brien, R., & Murray, P. (2020). Decreasing central lineassociated bloodstream infections acquired in the home setting among pediatric oncology patients. Journal of Pediatric Oncology Nursing, 37(3), 204–211. https://doi.org/10.1177/1043454220907551 Bailie, K., Jacques, L., Phillips, A., & Mahon, P. (2021). Exploring perceptions of education for central venous catheter care at home. Journal of Pediatric Oncology Nursing, 38(3), 157165. https://doi.org/10.1177/1043454221992293 Beauchamp-Walters, J., Syrkin-Nikolau, M. S., Garcia, M. A., Mattox, J., Pong, A., Rungvivatjarus, T., Lawrence, S., Baxter, R., Neder, C., Clark, M. D., & Pierce, H. (2024). Reducing pediatric ambulatory central line-associated bloodstream infections in patients at a single institution home health agency. American Journal of Infection Control, 52(10), 1195–1201. https://doi.org/10.1016/j.ajic.2024.06.003 Centers for Disease Control and Prevention. (2024). Intravascular catheter-related infection (BSI) prevention guidelines. Retrieved February 13, 2026, from https://www.cdc.gov/infection-control/hcp/intravascular-catheter-relatedinfection/index.html 25 Centers for Disease Control and Prevention. (2025, June 12). CLABSI basics: Central line-associated bloodstream infections (For everyone). https://www.cdc.gov/clabsi/about/index.html Children’s Hospitals Association. (n.d.). Children’s Hospitals Association. Retrieved February 20, 2026, from https://www.childrenshospitals.org/ Foucault-Fruchard, L., van der Mee, N., Reinprecht, C., Durand, C., Cailhol, J., Zahar, J. R., & Kerneis, S. (2025). Impact of educational interventions provided to patients with a central venous catheter and their informal caregivers: A systematic review. Antimicrobial Resistance & Infection Control, (14) 67. https://doi.org/10.1186/s13756-025-01583-w Institute for Healthcare Improvement. (n.d.). Model for Improvement. IHI. Retrieved September 7, 2025, from https://www.ihi.org/library/model-for-improvement Keller, S. C., Oladapo-Shittu, O., Maragakis, L. L., Salinas, A. B., Helsel, T., Hsu, Y.-J., Rock, C., & Cosgrove, S. E. (2024). Preparation of patients for central venous catheter care in the home: Perspectives from health care personnel. American Journal of Medical Quality, 39(5), 220–228. https://doi.org/10.1097/JMQ.0000000000000203 Longhini, J., Ambrosi, E., Tescaro, B., Derugna, N., Ferro, M. L., & Canzan, F. (2025). Patient education during hospitalization from the perspective of nurse managers: A qualitative study. Nursing & Health Sciences, 27(1). https://doi.org/10.1111/nhs.70052 Luther, B., Wilson, R., Kranz, C. & Krahulec, M. (2019). Discharge processes: What evidence tells us is most effective. Orthopaedic Nursing, 38(5), 328-333. https://doi.org/10.1097/NOR.0000000000000601 McMullen, K., Hixson, F., Peters, M., Nelson, K., Sistrunk, W., Reames, J., Standlee, C., Tannehill, D., & Starke, K. (2025). Prevention of central line–associated bloodstream 26 infections by leadership focus on process measures. Joint Commission Journal on Quality and Patient Safety, 51(2), 126–134. https://doi.org/10.1016/j.jcjq.2024.12.006 National Home Infusion Association. (n.d.). NHIF infusion industry trends report. Retrieved December 15, 2025, from https://nhia.org/nhif/nhif_research/nhif_infusion_industry_trends_report/ New York State Department of Health. (n.d.). What are we trying to improve? Components of improvement. Retrieved September 20, 2025, from https://www.health.ny.gov/statistics/chac/improvement/components.htm Pueyo-Garrigues, M., Pardavila-Belio, M. I., Canga-Armayor, A., Esandi, N., Alfaro-Díaz, C., & Canga-Armayor, N. (2022). Nurses’ knowledge, skills and personal attributes for providing competent health education practice, and its influencing factors: A crosssectional study. Nurse Education in Practice, 58, 103277. https://doi.org/10.1016/j.nepr.2021.103277 Reed, J. E., Davey, N., & Woodcock, T. (2016). The foundations of quality improvement science. Future Hospital Journal, 3(3), 199–202. https://doi.org/10.7861/futurehosp.3-3199 Rinke, M. L., Milstone, A. M., Chen, A. R., Mirski, K., Bundy, D. G., Colantuoni, E., Pehar, M., Herpst, C., & Miller, M. R. (2013). Ambulatory pediatric oncology CLABSIs: Epidemiology and risk factors. Pediatric Blood & Cancer, 60(11), 1882-1889. https://doi.org/10.1002/pbc.24677 St. Ambrose University Library. (n.d.). Nursing scholarly sources guide: Professional dissemination. Retrieved January 15, 2026, from https://libguides.sau.edu/c.php?g=1395690&p=10391856 27 St. John, I. J., & Englund, H. M. (2020). Improving patient discharge education through daily educational bursts: A pilot study. Journal for Nurses in Professional Development, 36(5), 283–287. https://doi.org/10.1097/NND.0000000000000627 Ullman, A. J., & Chopra, V. (2025). Routine care and maintenance of intravenous devices. UpToDate. Retrieved February 20, 2026, from https://www.uptodate.com/contents/routine-care-and-maintenance-of-intravenous-devices United Hospital Fund. (2017, March 15). Caring for your peripherally inserted central catheter (PICC): A guide for patients and family caregivers. https://uhfnyc.org/publications/publication/caring-for-your-peripherally-inserted-centralcatheter-picc-a-guide-for-patients-and-family-caregivers/ Wong, C. I., Ilowite, M., Yan, A., Mahan, R. M., Desrochers, M. D., Conway, M., & Billett, A. L. (2024). Reducing ambulatory central line-associated bloodstream infections: A familycentered approach. Pediatric Blood & Cancer, 71(8). https://doi.org/10.1002/pbc.31064 28 Appendix A The Journey Home Board 29 Appendix B Practice Change Hospital Factsheet 30 Appendix C Training Presentation for Bedside Nurses 31 32 33 34 Appendix D Pre- and Post-Implementation Nurse Comfort Surveys 35 36 37 38 Appendix E Project Timeline