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

Clinical and Experimental Pediatrics
Chanapai Chaiyakulsil, Onsuthi Pharadornuwat

Abstract

The use of indwelling central venous access devices (CVADs) in children can result in complications such as infection, occlusion, and dislodgement. To evaluate whether reinforcing CVAD care bundles by using a regular direct feedback system could reduce such complications in children. The intervention in this retrospective interrupted time-series study was initiated in January 2019. The study was divided into the preintervention (October-December 2018), 3-month postintervention (January-March 2019), and 6-month postintervention (April-June 2019) phases. Risk difference and Poisson regression analyses were used to illustrate the effectiveness of the intervention. The hospital-wide central line-related bloodstream infection rate decreased from 10.0/1,000 catheter-days to 4.5/1,000 catheter-days at 3-month postintervention (P=0.39) and to 1.4/1,000 catheter-days at 6-month postintervention (P=0.047). The central line occlusion rate significantly decreased from 30% to 12.8% (P=0.04) and 8.3% (P=0.002) at 3 and 6 months, respectively. Approximately 7% of CVADs became dislodged during the preintervention phase versus 8.5% (P=0.364) and 3.3% (P=0.378) at 3 and 6 months, respectively. Reinforcing CVAD care bundles with direct feedback c...Continue Reading

References

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