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Central line bundle including split-septum device and single-use prefilled flushing syringes to prevent
İlker Devrim1, Mustafa Taha Özkul2, İlknur Çağlar3
1Department of Pediatric Infectious Diseases, Dr. Behçet Uz Children's Hospital, İzmir, Turkey. ilkerdevrim2003@yahoo.com.
Insights
Implementing central line bundles significantly reduced central line-associated bloodstream infections (CLABSI) and associated costs in pediatric cancer patients. The program proved cost-effective, with savings from prevented infections exceeding implementation expenses.
Area of Science:
- Pediatric Oncology
- Healthcare Economics
- Infection Control
Background:
- Central line bundles effectively reduce central line-associated bloodstream infections (CLABSI) in pediatric cancer patients with ports.
- Limited cost-effectiveness data exists for these programs in pediatric oncology, with most studies focusing on adult or ICU populations.
Purpose of the Study:
- To assess the cost-effectiveness of central line bundle programs in reducing CLABSI in pediatric cancer patients.
- To analyze healthcare costs associated with CLABSI before and after bundle implementation.
Main Methods:
- A 6-year cross-sectional study was conducted in a pediatric hematology-oncology ward.
- Total healthcare costs attributable to CLABSI in patients with ports were comprehensively assessed over two distinct periods.
Main Results:
- CLABSI rates decreased significantly from 8.31 to 3.04 per 1000 central line days (p < 0.001).
- Total attributable costs for CLABSI decreased from $130,661 in the pre-bundle period to $116,579 in the bundle period.
- The implementation of central line bundles prevented 71 CLABSIs, resulting in an additional cost saving of $208,977.
Conclusions:
- Central line bundles effectively decrease both CLABSI rates and associated healthcare expenditures.
- The cost of implementing bundle elements was offset by the savings generated from preventing high-cost CLABSIs.
Background:
Central line bundle programs were found to be effective in decreasing central line-associated bloodstream infection rates in pediatric cancer patients with ports. However, cost-effectiveness studies of central line bundle programs in pediatric cancer patients are limited, and most available data are from intensive care unit or adult studies.
Methods:
In this cross-sectional study spanning 6 years, comprehensive assessment of total health care costs attributable to CLABSI's associated with ports between two periods.
Results:
This cross-sectional study was carried out in the pediatric hematology-oncology ward of Dr. Behçet Uz Children's Hospital from 1 August November 2011 to 31 July 2017. The CLABSI rates decreased significantly from 8.31 CLABSIs to 3.04 per 1000 central line days (p < 0.001). In the pre-bundle period, total attributable costs spent for of patients with CLABSI were $130,661, and in the bundle period, total attributable costs spent for patients with CLABSI were $116,579. Within bundle implantation, 71 potential CLABSI were prevented, which saved an additional $208,977.
Conclusion:
Our study shows that central line bundles decreases not only the CLABSI rate but also decreases attributable costs due to CLABSI. Expenses spent for bundle elements, were covered by savings by preventing CLABSI with higher costs.
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