Implementing an Oral Health Educator Contributes to Reduced MBI-CLABSI Rates for Pediatric Hematopoietic Stem Cell...

Area of Science:

• Oncology
• Infectious Diseases
• Dental Medicine

Background:

• Mucosal barrier injury central line-associated bloodstream infections (MBI-CLABSIs) are a significant concern in pediatric cancer patients.
• These infections often stem from oral or gastrointestinal bacteria entering the bloodstream through compromised mucosal barriers.
• Current prevention strategies primarily focus on gut integrity, neglecting oral pathogen control.

Purpose of the Study:

• To decrease MBI-CLABSI rates in pediatric hematopoietic stem cell transplant (HSCT) patients.
• To enhance oral care adherence among this vulnerable patient population.
• To evaluate the impact of an integrated oncodental collaboration.

Main Methods:

• A quality improvement project utilizing two Plan-Do-Study-Act (PDSA) cycles was implemented.
• PDSA cycle 1 involved integrating dental residents into weekly patient rounds for screening and education.
• PDSA cycle 2 introduced a dedicated oral health educator (OHE) providing regular, targeted oral care.

Main Results:

• MBI-CLABSI rates decreased by 58.8% (from 5.1 to 2.1 events per 1,000 central venous line days).
• Oral care adherence improved by 41.7% (from 60.9% to 86.3%).
• An estimated annual cost saving of $541,000 was achieved.

Conclusions:

• The implementation of an oral health educator role demonstrably improved patient outcomes in pediatric HSCT units.
• This role offers a valuable and cost-effective strategy for reducing MBI-CLABSIs originating from oral pathogens.
• The findings support the integration of oral health services into inpatient oncology care.