We conclude that our collaborative quality improvement project demonstrated that significant reduction in CVC-associated BSI rates and related costs can be realized by means of evidence-based prevention interventions, enhanced communication among caregivers, standardization of CVC insertion and maintenance processes, enhanced measurement, and empowerment of team members to enforce adherence to best practices.

Delirium in children is an often underrecognized but serious complication of hospitalization. Delirium in this age group has been described as behaviors such as refractory agitation and restlessness, visual or auditory hallucinations, children being "not themselves," and a lethargic state. Often, children with delirium are at risk for harming themselves by dislodging tubes, falling, or refusing care. Pediatric nurses must recognize and intervene to prevent and treat delirium in hospitalized children because the delirium may be an indicator of worsening clinical status and is associated with high mortality and morbidity in children of all ages and with posttraumatic stress disorder. Pediatric nurses are uniquely positioned to design care interventions to both reduce risk for delirium and treat active delirium. Many treatment recommendations are nonpharmacological and are part of excellent nursing care. (Critical Care Nurse. 2017; 37[3]:e9-e18)

Nurses play an important role in supporting families who are faced with the critical illness and death of their child. Grieving families desire compassionate, sensitive care that respects their wishes and meets their needs. 1-5 Some nurses feel anxiety related to the experience of death and are inadequately prepared to provide end-of-life care. 3,6,7 We begin by presenting a case that illustrates a family's response when faced with such a life-altering event and the challenges nurses face in caring for and communicating with the family throughout the end-of-life experience. Next, we review practical strategies that nurses can use to communicate with patients' families at the end of a child's life. We also provide additional strategies to provide compassionate, sensitive care that respects a family's wishes and attends to the needs of the family. Finally, we describe a bereavement program designed to facilitate lasting communication with the grieving family. This article has been designated for CE credit. A closed-book, multiple-choice examination follows this article, which tests your knowledge of the following objectives:1. Describe the challenges nurses face in caring for and communicating with the family throughout the end-of-life experience 2. Discuss strategies to provide compassionate care that respects a family's wishes and attends to the needs of the family throughout the end-of-life experience 3. Identify strategies that nurses can use to communicate with patients' families at the end of a child's life CE Continuing Education 46