Table 1 Study characteristics

Engel et al., 2023

2018–2021,

B = 24 months,

I = 14 months

3 hospitals: 1 university hospital and 2 community hospitals (34 units, 983 beds)

HCWs in adult and paediatric acute care wards

An e-learning module on CHG bathing (background on the evidence and short video) was available for HCW. An electronic reminder in the EHR for daily CHG bathing created a worklist task for nurses and nursing assistants.

Hugo et al., 2022

2017–2021 ;

B = 12 months ; I = 27 months

1 quaternary care, pediatric academic hospital (7 inpatient units, 364 beds)

Nurses in paediatric ICU and non-ICU wards

A digital application (Rounds+^®) assisted nurses during CVC maintenance rounds by documenting key bundle elements, including line access, dressing changes/port needle insertions, and cap changes. A dedicated nurse recorded observations in the app and marked any protocol deviations as “done with correction” when the deviation was addressed in real-time.

Chemparathy et al., 2021

2015–2019

B= 30 months;

I = 15 months

1 pediatric academic hospital (395 beds)

HCWs (physician and nurses) in paediatric ICU and non-ICU wards

An automated hospital-wide CLABSI bundle adherence system was implemented via a dashboard. The dashboard was integrated into the EHR and provided visual representations of bundle-adherence rates across units and bundle elements. Adherence calculations were based on data entered by nursing staff into the EHR during bundle checks.

Orwol et al., 2018

2014–2015 ;

B = 12 months ; I = 12 months

1 pediatric academic hospital

Nurses working in paediatric ICU and non-ICU wards

The application (CLABSI App^®) served as a self-assessment tool for CVC care. It integrated just-in-time microlearning with in-line explanations of institutional CLABSI prevention bundle elements, on-demand video demonstrations, and visualization of self-reported compliance. Users could compare their performance to unit-wide aggregates, and the app supported customized teams and competitions across shifts and units.

Pageler et al., 2014

2009–2012 ;

B = 23 months;

I = 4 months

1 PICU (24 beds) in an academic pediatric hospital

HCWs in PICU

An electronic dashboard was integrated into the EHR with a specific interface for each patient to highlight critical clinical data and ensure compliance with evidence-based best practices for CVC insertion and maintenance. The page displayed actionable items, color-coded visual indicators for compliance, and an integrated checklist combining elements of pediatric-specific CVC insertion and maintenance bundles for CLABSI prevention. The checklist was dynamically linked to nursing and physician documentation, displaying only relevant components and providing educational links to support clinician decision-making. In addition, an electronic multipatient dashboard was displayed in the PICU.

Bae et al., 2022

2018–2021 ;

B = 16 months ;

I = 14 months

1 single tertiary care hospital

HCWs in adult ICU

An automatic notification of CVC-days in the electronic healthcare system was introduced. It displayed the CVC indwelling days in the prescription section of the electronic healthcare system. Medical staff evaluated the need for a CVC every day. Until the assessment of CVC maintenance was completed, the automatic notification of catheter days continued.