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Can central venous access device care bundles and regular feedback reduce central line-associated complications in

Chanapai Chaiyakulsil1, Onsuthi Pharadornuwat1

  • 1Division of Pediatric Critical Care, Department of Pediatrics, Faculty of Medicine, Thammasat University, Prathumthani, Thailand.

Clinical and Experimental Pediatrics
|July 21, 2020
PubMed

Insights

Implementing direct feedback on central venous access device (CVAD) care bundles significantly reduced infections and occlusions in children. This quality improvement strategy enhanced patient safety by minimizing device-related complications.

Area of Science:

  • Pediatric healthcare quality improvement
  • Central venous access device management
  • Patient safety in pediatrics

Background:

  • Indwelling central venous access devices (CVADs) are essential in pediatric care but associated with significant complications.
  • Common CVAD complications include infection, occlusion, and dislodgement, impacting patient outcomes.
  • Effective management strategies are crucial to mitigate these risks in pediatric patients.

Purpose of the Study:

  • To assess the impact of reinforcing CVAD care bundles with a direct feedback system on complication rates in children.
  • To determine if enhanced adherence to care bundles through feedback improves safety outcomes.
  • To evaluate the effectiveness of a quality improvement intervention in reducing CVAD-related adverse events.

Main Methods:

  • A retrospective, interrupted time-series study design was employed.
  • The intervention involved implementing a regular direct feedback system for CVAD care bundles.
  • Data were collected across preintervention and 3- and 6-month postintervention phases, analyzed using Poisson regression.

Main Results:

  • Central line-related bloodstream infection rates decreased significantly by 6 months postintervention (1.4/1,000 catheter-days).
  • Central line occlusion rates showed a significant reduction at both 3 months (12.8%) and 6 months (8.3%) postintervention.
  • While dislodgement rates showed a trend towards reduction, they did not reach statistical significance within the study period.

Conclusions:

  • Reinforcing CVAD care bundles with direct feedback is an effective strategy to reduce infection and occlusion complications in pediatric patients.
  • The study demonstrates that regular direct feedback can enhance the quality of care for children requiring CVADs.
  • This quality improvement initiative highlights the potential for feedback systems to improve patient safety and reduce device-related morbidity.
Abstract

Keywords:
Central line infectionOcclusionPatient care bundlesPediatricsPrevention

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