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Multi-level Intervention Program - A Quality Improvement Initiative to Decrease Central Line-Associated Bloodstream

Karla Marie Bathan Santos1, Sufia S Husain2, Vanessa Torres3

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|August 5, 2019
PubMed
Summary

Implementing an intervention significantly reduced central line-associated bloodstream infections (CLABSIs) in pediatric patients. While staff adherence was high, parent adherence was low, highlighting a need for targeted parent education to further prevent CLABSIs.

Keywords:
Acute care pediatricsCentral line associated blood stream infectionCentral venous catheter bundlePediatric hematology and oncologyQuality improvement

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Area of Science:

  • Pediatric Healthcare
  • Infection Prevention and Control
  • Clinical Interventions

Background:

  • Central venous catheters (CVCs) are essential for pediatric patients requiring long-term intravenous therapy.
  • CVC use increases the risk of central line-associated bloodstream infections (CLABSIs).
  • Effective infection control strategies are crucial in pediatric care settings.

Purpose of the Study:

  • To evaluate adherence to intervention components aimed at reducing CLABSIs in pediatric units.
  • To assess the impact of the intervention on CLABSI rates over a five-year period.
  • To identify factors influencing adherence and infection rates.

Main Methods:

  • A multi-component intervention was implemented across pediatric acute care and hematology-oncology units.
  • Adherence was monitored using a CVC audit sheet.
  • CLABSI rates were collected quarterly for five years, comparing pre- and post-intervention periods.

Main Results:

  • CLABSI rates demonstrated a steady decrease over the five-year study period.
  • Staff adherence to intervention components ranged from 90% to 100%, with lowest adherence to patient protective equipment (PPE).
  • Hospital-acquired CLABSIs decreased from 41 incidents pre-intervention to 9 incidents post-intervention.

Conclusions:

  • The intervention was effective in reducing CLABSI rates in pediatric units.
  • Sustained high staff adherence is critical for infection prevention.
  • Low parent/family adherence necessitates targeted strategies, including enhanced education and visible reminders for PPE compliance.