Enhanced central venous catheter bundle for pediatric parenteral-dependent intestinal failure

American Journal of Infection Control
Jennifer A OrmsbyGrace M Lee

Abstract

Central line-associated bloodstream infections (CLABSIs) cause substantial morbidity and increase antimicrobial use and length of stay among hospitalized children in the United States. CLABSI occurs more frequently among high-risk pediatric patients, such as those with intestinal failure (IF) who are parenteral nutrition (PN) dependent. Following an increase in CLABSI rates, a quality improvement (QI) initiative was implemented. Using QI methodology, an enhanced central venous catheter (CVC) maintenance bundle was developed and implemented on 2 units for pediatric PN-dependent patients with IF. CLABSI rates were prospectively monitored pre- and postimplementation, and bundle element adherence was monitored. Enhanced bundle elements included chlorhexidine-impregnated patch, daily bathing, ethanol locks, 2 nurses for CVC care in a distraction-free zone, peripheral laboratory draws, bundling routine laboratory tests, and PN administration set changes every 24 hours. Adherence to enhanced bundle elements increased to >90% over 3 months. CLABSI rates averaged 1.41 per 1,000 central line days preimplementation compared with 0.40 per 1,000 device days postimplementation (P = .003), an 85% absolute reduction in CLABSI rates over 12 mon...Continue Reading

Citations

Jun 7, 2019·The American Journal of Clinical Nutrition·Aureliane Chantal Stania PierretJake Peter Mann
Jun 5, 2020·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·Jennifer A OrmsbyThomas J Sandora
Dec 29, 2020·Expert Opinion on Drug Safety·Jordan D SecorKathleen M Gura
Apr 17, 2021·Current Gastroenterology Reports·Danielle WendelValeria C Cohran
May 23, 2021·JPEN. Journal of Parenteral and Enteral Nutrition·Ethan A MezoffMolly Dienhart

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