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Published on: July 13, 2019

Empowering Caregivers, Protecting Patients: An Ambulatory Central Line Quality Improvement Initiative for Education

Elizabeth Martinez1, Belinda Bordeaux2, Stephanie Langevin3

  • 1From the Clinical Practice and Education, Children's Hospital of The King's Daughters, Norfolk, VA.

Pediatric Quality & Safety
|July 17, 2026
PubMed

Insights

A new standardized education program significantly reduced ambulatory central line-associated bloodstream infections (A-CLABSIs) in pediatric intestinal failure patients by nearly 50%. The program improved home care confidence for families and healthcare providers.

Area of Science:

  • Infection Prevention and Control
  • Pediatric Gastroenterology
  • Healthcare Education

Background:

  • Ambulatory central line-associated bloodstream infections (A-CLABSIs) pose a significant challenge, particularly for pediatric intestinal failure (IF) patients, due to inconsistent home care practices.
  • Existing education and follow-up protocols were insufficient, necessitating a targeted intervention to improve patient outcomes.

Purpose of the Study:

  • To decrease the A-CLABSI rate in pediatric IF patients by 25% within two years.
  • To implement and evaluate a standardized, step-by-step central line care education program for patients and healthcare providers.

Main Methods:

  • A two-phase education program was developed using the Toyota problem-solving method.
  • Phase 1 involved in-hospital education with videos, handouts, and hands-on training, alongside expanded training for home health agencies.
  • Phase 2 incorporated post-discharge follow-up via phone calls or clinic visits, with family feedback collected through surveys.

Main Results:

  • The average IF A-CLABSI rate decreased by 49.5%, from 3.66 to 1.85 per 1,000 ambulatory line days.
  • 100% of surveyed families reported increased confidence in home central line care post-discharge.
  • Home health staff demonstrated a 47% improvement in knowledge scores after training, valuing the hands-on component.

Conclusions:

  • The standardized education program effectively reduced IF A-CLABSIs and enhanced patient safety.
  • The intervention improved confidence and satisfaction among families and home health nurses.
  • The program fostered improved collaboration and continuity of care between families, home health agencies, and the healthcare system.
Abstract

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