• Bat-Erdene Ider, Jon Adams, Anthony Morton, Michael Whitby, Tsolmon Muugolog, Ganbold Lundeg, and Archie Clements.
• School of Population Health, University of Queensland, Room 303, Edith Cavell Building, Herston Road, Herston, QLD 4006, Australia. Ibaterdene@yahoo.com
• Int. J. Infect. Dis. 2012 Jul 1;16(7):e551-7.

ObjectivesThis study aimed to determine the extent to which a checklist has potential for identifying barriers to compliance with central line management guidelines, to evaluate the potential utility of checklists to improve the management of central lines in Mongolia, and to define the gap between current and best practices.MethodsA 22-item checklist was developed based on the Centers for Disease Control and Prevention (CDC, USA) guidelines and existing central line-associated bloodstream infection (CLABSI) checklists. The checklist was used to observe 375 central line procedures performed in the intensive care units of four tertiary hospitals of Mongolia between July and December 2010. In parallel, 36 face-to-face interviews were conducted in six other tertiary hospitals to explain practice variations and identify barriers.ResultsThe baseline compliance level across all components of the checklist was 68.5%. The main factors explaining low levels of compliance were outdated local standards, a lack of updated guidelines, poor control over compliance with existing clinical guidelines, poor supply of medical consumables, and insufficient knowledge of contemporary infection control measures among health care providers.ConclusionsThe health authorities of Mongolia need to adequately address the prevention and control of CLABSIs in their hospitals. Updating local standards and guidelines and implementing adequate multifaceted interventions with behavioral, educational, and logistical components are required. Use of a checklist as a baseline evaluation tool was feasible. It described current practice, showed areas that need urgent attention, and provided important information needed for future planning of CLABSI interventions.Copyright © 2012 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

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