Related Experiment Video

Updated: Oct 8, 2025

A Protocol to Set Up Needle-Free Connector with Positive Displacement on Central Venous Catheter in Intensive Care Unit
09:57

A Protocol to Set Up Needle-Free Connector with Positive Displacement on Central Venous Catheter in Intensive Care Unit

Published on: July 13, 2019

13.2K

Stewardship Intervention to Optimize Central Venous Catheter Utilization in Critically Ill Children

Jennifer A Blumenthal1,2,3, Jennifer A Ormsby4, Dimple Mirchandani1

  • 1Department of Anesthesiology, Critical Care and Pain Medicine, Division of Critical Care Medicine, Boston Children's Hospital, Boston, Mass.

Pediatric Quality & Safety
|December 29, 2021
PubMed

Insights

A quality improvement initiative reduced long-term central venous catheter (CVC) use in a pediatric intensive care unit (PICU). CVC stewardship rounds and education decreased device utilization, enhancing patient care and safety.

Area of Science:

  • Pediatric critical care medicine
  • Healthcare quality improvement
  • Infection control

Background:

  • Long-term central venous catheters (CVCs) are crucial in pediatric intensive care units (PICUs) but associated with risks.
  • Strategies to optimize CVC utilization and reduce associated complications are essential.

Purpose of the Study:

  • To describe the utilization and indications for long-term CVCs in a PICU.
  • To identify strategies for decreasing long-term CVC utilization.
  • To evaluate the impact of a CVC stewardship program on device use.

Main Methods:

  • A prospective quality improvement initiative was conducted in a 30-bed PICU.
  • An electronic report identified patients with CVCs for ≥7 days (long-term).
  • Weekly interdisciplinary CVC stewardship rounds recommended CVC removal, supported by Plan-Do-Study-Act cycles.

Main Results:

  • 607 long-term CVCs were eligible for intervention from October 2016 to September 2017.
  • A significant increase in peripherally inserted central catheters and a decrease in nontunneled CVCs were observed (P < 0.001).
  • Overall long-term CVC utilization, particularly for modifiable indications, decreased during the intervention period.

Conclusions:

  • A single-center quality improvement intervention focused on CVC stewardship effectively reduced CVC utilization in the PICU.
  • The findings support the implementation of CVC stewardship programs to optimize device use in pediatric critical care settings.

More Related Videos

A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings06:59

A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings

Published on: November 9, 2016

30.7K
Author Spotlight: Hickman Catheter Use for Long-Term Vascular Access in a Preclinical Swine Model08:51

Author Spotlight: Hickman Catheter Use for Long-Term Vascular Access in a Preclinical Swine Model

Published on: March 31, 2023

4.6K

Related Concept Videos

Parentral Nutrition: Centeral and Peripheral Parental Nutrition01:27

Parentral Nutrition: Centeral and Peripheral Parental Nutrition

Parenteral Nutrition (PN) delivers essential nutrients directly into the bloodstream, bypassing the digestive system. It is commonly used for individuals with severe digestive disorders or conditions that prevent normal nutrient absorption.
PN can be administered through two primary routes:
1. Central Parenteral Nutrition (CPN):
CPN involves delivering a high concentration of nutrients through a large vein. This is typically achieved using a Peripherally Inserted Central Catheter (PICC) or,...
344
Cardiac Catheterization IV: Nursing Management01:26

Cardiac Catheterization IV: Nursing Management

Nursing responsibilities before cardiac catheterization include:Assess for allergies and establish baseline health status.Before cardiac catheterization, assess the patient for allergies to contrast dye. Perform a comprehensive baseline assessment, including vital signs, heart and breath sounds, and a neurovascular assessment of the extremities, noting distal pulses, skin color, and temperature. Instruct the patient to fast for 8-12 hours before the procedure. Evaluate baseline laboratory...
257
Venous Thrombosis III: Interprofessional Care01:29

Venous Thrombosis III: Interprofessional Care

Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
52
Endocarditis IV: Nursing Management01:29

Endocarditis IV: Nursing Management

Infective endocarditis (IE) is a chronic infection of the heart's endocardium, primarily affecting the heart valves. A detailed nursing assessment for a patient with IE involves collecting subjective and objective data to ensure an accurate diagnosis and timely intervention.Subjective DataThe nurse gathers information about the patient's symptoms and complaints during the subjective assessment. Patients with infective endocarditis often report non-specific symptoms that can mimic other...
73
Hemodialysis III: Nursing Management01:25

Hemodialysis III: Nursing Management

The nursing management of a patient undergoing hemodialysis includes several critical steps, starting with a thorough assessment before the procedure.Before the Hemodialysis ProcedureFirst, record the patient's vital signs—blood pressure, heart rate, respiratory rate, and temperature—to establish a baseline. This baseline is essential for detecting conditions such as hypotension that could impact the patient's response to dialysis. Document the patient's pre-dialysis weight, as this...
262
Extracorporeal Removal of Drugs: Continuous Renal Replacement Therapy01:26

Extracorporeal Removal of Drugs: Continuous Renal Replacement Therapy

Continuous Renal Replacement Therapy (CRRT) is an essential intervention for patients experiencing severe kidney dysfunction. This therapy offers a continuous mechanism for removing fluids and toxins from the bloodstream, leveraging the patient’s blood pressure to facilitate filtration through a specialized filter. This method contrasts with intermittent dialysis, providing a gentler and more consistent removal of waste products and excess fluid, which is particularly beneficial in...
12