Preventing CLABSIs among pediatric hematology/oncology inpatients: national collaborative results

Central lines (CLs) are essential for the delivery of modern cancer care to children. Nonetheless, CLs are subject to potentially life-threatening complications, including central line-associated bloodstream infections (CLABSIs). The objective of this study was to assess the feasibility of a multice...

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Vydáno v:Pediatrics (Evanston) Ročník 134; číslo 6; s. e1678
Hlavní autoři: Bundy, David G, Gaur, Aditya H, Billett, Amy L, He, Bing, Colantuoni, Elizabeth A, Miller, Marlene R
Médium: Journal Article
Jazyk:angličtina
Vydáno: United States 01.12.2014
Témata:
Bacteremia - prevention & control
Bacteremia - transmission
Catheter-Related Infections - prevention & control
Catheterization, Central Venous - standards
Child
Cooperative Behavior
Cross Infection - prevention & control
Cross Infection - transmission
Hematologic Diseases - therapy
Hospitals, Pediatric - organization & administration
Hospitals, Pediatric - standards
Humans
Inservice Training - organization & administration
Inservice Training - standards
Interdisciplinary Communication
Neoplasms - therapy
Oncology Service, Hospital - organization & administration
Oncology Service, Hospital - standards
Quality Assurance, Health Care - organization & administration
Quality Assurance, Health Care - standards
Quality Improvement - organization & administration
Quality Improvement - standards
Risk Factors
United States
United States
hospital oncology service
cross infection
quality improvement
catheter-related infections
bacteremia
ISSN:1098-4275, 1098-4275
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Shrnutí:Central lines (CLs) are essential for the delivery of modern cancer care to children. Nonetheless, CLs are subject to potentially life-threatening complications, including central line-associated bloodstream infections (CLABSIs). The objective of this study was to assess the feasibility of a multicenter effort to standardize CL care and CLABSI tracking, and to quantify the impact of standardizing these processes on CLABSI rates among pediatric hematology/oncology inpatients. We conducted a multicenter quality improvement collaborative starting in November 2009. Multidisciplinary teams at participating sites implemented a standardized bundle of CL care practices and adopted a common approach to CLABSI surveillance. Thirty-two units participated in the collaborative and reported a mean, precollaborative CLABSI rate of 2.85 CLABSIs per 1000 CL-days. Self-reported adoption of the CL care bundle was brisk, with average compliance approaching 80% by the end of the first year of the collaborative and exceeding 80% thereafter. As of August 2012, the mean CLABSI rate during the collaborative was 2.04 CLABSIs per 1000 CL-days, a reduction of 28% (relative risk: 0.71 [95% confidence interval: 0.55-0.92]). Changes in self-reported CL care bundle compliance were not statistically associated with changes in CLABSI rates, although there was little variability in bundle compliance rates after the first year of the collaborative. A multicenter quality improvement collaborative found significant reductions in observed CLABSI rates in pediatric hematology/oncology inpatients. Additional interventions will likely be required to bring and sustain CLABSI rates closer to zero for this high-risk population.
Bibliografie:ObjectType-Article-1
SourceType-Scholarly Journals-1
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ISSN:1098-4275
1098-4275
DOI:10.1542/peds.2014-0582