Evaluation of the Saudi national prevention model for reduction of central-line-associated bloodstream infections: A single-center qualitative study

Aim Central-line catheterization is a routine but high-risk procedure in intensive care, with central-line–associated bloodstream (CLABSI) infections remaining a major contributor to patient morbidity, prolonged hospitalization, and increased healthcare costs. In response to nationally elevated CLABSI rates, the Saudi Ministry of Health introduced the “ Go Green ” Project and the CLABSI National Prevention Tool in 2022 to standardize and strengthen prevention practices. Objective To evaluate the national prevention model in a tertiary adult intensive care unit. Methods We conducted semi-structured interviews, direct observations, and document reviews with 29 stakeholders, including nurses, physicians, infection-prevention specialists, and administrators. The study identified two major themes. The first one, “A practical strategy requires both professional human resources and sufficient medical supplies,” comprised four codes: staffing, workload overload, competency, and medical supplies. The second theme, “An administrative strategy requires both awareness and behavioral attitudes,” was represented by four codes: “ Go Green ,” education and training, hands-off practices, and teamwork. While participants generally demonstrated strong foundational knowledge of CLABSI prevention, gaps remained among a minority. Results Key barriers included nursing workforce shortages, inconsistent supply availability, and variable competency in ultrasound-guided catheter insertion. Stakeholders emphasized the need for continuous training, improved supply-chain reliability, and stronger interdisciplinary collaboration, alongside a sustained cultural commitment to infection-prevention practices. Significance and impact Although the institution achieved national recognition for CLABSI reduction in 2022, long-term success will depend on maintaining adherence to best practices, addressing operational constraints, and ensuring ongoing competency development to meet future performance targets.