CE Article: A Quality Improvement Approach in Standardizing Pediatric Central Venous Catheter Dressings and Its Impact on the Reduction of Central Line-Associated Bloodstream Infections and Costs

Kramer, Christopher; Doellman, Darcy; Blaser, Casey; Rosenberg, Robin Huneke; Bernatchez, Stéphanie F.

doi:10.2309/j.java.2019.002.002

Journal of the Association for Vascular Access

2019

DOI: 10.2309/j.java.2019.002.002

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CE Article: A Quality Improvement Approach in Standardizing Pediatric Central Venous Catheter Dressings and Its Impact on the Reduction of Central Line-Associated Bloodstream Infections and Costs

Christopher Kramer¹,

Darcy Doellman

Casey Blaser³

et al.

Abstract: Highlights A CVC dressing inventory is beneficial to pediatric patients. Dressing standardization reduced unplanned dressing changes and costs. In our study, the new dressing inventory helped reduce the CLABSI rate.

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Cited by 3 publications

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Implementation frameworks, strategies and outcomes in optimizing central venous access device practice in paediatrics: A scoping review

Comber,

Keogh,

Nguyen

et al. 2024

Journal of Advanced Nursing

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Paediatric patients with complex or acute conditions may require a central venous access device, however, almost one‐third of these devices have associated complications (e.g. infections). Implementation of evidence‐based practices regarding central venous access devices can reduce and potentially prevent complications.AimsThis scoping review aimed to explore recent interventional research in CVAD management through an implementation lens.DesignThis scoping review used the Arksey and O'Malley framework. Studies were included if they were written in English, published in 2012 to July 2023, involved children and were relevant to the study aims. Risk of bias was appraised by the Mixed Methods Appraisal Tool.Data SourcesSearches were undertaken in EMBASE, CINAHL (Ebsco), PubMed, Web of Science and Cochrane Library (CENTRAL).ResultsOf the 1769 studies identified in a systematic search, 46 studies were included. Studies mostly focused on health professionals and central venous access device maintenance and had quantitative pre‐post study designs. Adherence to implementation frameworks was lacking, with many studies employing quality improvement approaches. Implementation strategies were typically multipronged, using health‐professional education, bundles and working groups. Bundle compliance and reductions in central line‐associated bloodstream infections were the most featured outcomes, with most studies primarily focusing on effectiveness outcomes.ConclusionTranslation of evidence‐based practices to the clinical setting is difficult and current adoption of implementation frameworks (apart from ‘quality improvement’) is limited. Implementation strategies are diverse and dependent on the local context, and study outcomes typically focus on the effectiveness of the physical intervention, rather than measuring the implementation effort itself.Implications for PatientsFuture intervention research requires a more uniform and deliberate application of implementation frameworks and strategies.ImpactGreater exploration of relationships between frameworks and strategies and implementation and service outcomes is required to increase understanding of their role in maximizing resources to improve health care.Adhered to best reporting guidelines as per PRISMA‐ScR (Tricco et al., 2018).Patient or Public ContributionNo patient or public contribution.

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Implementation frameworks, strategies and outcomes in optimizing central venous access device practice in paediatrics: A scoping review

Comber,

Keogh,

Nguyen

et al. 2024

Journal of Advanced Nursing

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Metodologías Lean en salud. Propuesta de mapa analítico-conceptual para sistematizar su impacto y resultados

Danet,

Pérez Lázaro

2024

Rev. Ger. Pol. Sal

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Objetivo: Diseñar una propuesta teórico-metodológica para sistematizar los resultados del uso de metodologías Lean en salud y aplicar dicho modelo en el ámbito sanitario occidental. Metodología: Se diseñó una herramienta teórico-metodológica que combina los sistemas de indicadores del modelo de Donabedian, el Sistema Nacional de Salud y el modelo de Atención Sanitaria Basada en el Valor. El mapa analítico-conceptual creado se aplicó en una revisión sistemática de estudios empíricos cuantitativos y mixtos publicados en los últimos cinco años sobre el impacto de Lean en salud. Resultados: Los 33 estudios analizados, principalmente diseños cuantitativos pre-post, describen y evalúan el impacto de diversas intervenciones Lean (flujo de valor, ciclo PDSA/PDCA, Lean Six Sigma y eventos Kaizen) orientadas a mejorar la eficiencia y la calidad asistencial. La mayoría de los estudios se concentran en contextos hospitalarios (quirófanos, cuidados intensivos y farmacia) y en mediciones centradas en el eje organizacional (oferta de servicios, accesibilidad, gestión del tiempo y organización del trabajo, reducción de costos, eficiencia y seguridad), con menor atención a los aspectos centrados en el valor para los pacientes (resultados en salud, satisfacción y efectos a largo plazo). Conclusiones: El análisis estructurado basado en el mapa analítico-conceptual permitió dimensionar los resultados de Lean en salud, identificar las áreas de gestión y calidad con mayor aplicación e impacto Lean, y señalar la necesidad de ampliar las investigaciones en torno al valor para los pacientes.

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The Effect of Applying Nursing Care Bundle on Controlling Central Venous Line Infection in Neonatal Intensive Care Units

Alfar

El-Sheikh

Hassan

et al. 2020

Mansoura Nursing Journal

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Central venous line (CVL) is a necessary device used frequently in neonatal intensive care units (NICUs) for critically ill neonates who need continuous monitoring and resuscitation treatment. Significant evidence has accumulated indicating that CVL nursing care bundle is considered as an essential component of CVL infection prevention practice to combat the incidence of CVL infection. Aim: This study aimed to examine the effect of applying nursing care bundle on controlling central venous line infection in neonatal intensive care units. Subject and method: A quasi-experimental design was used. The study was conducted at NICU at Kafr El Sheikh General Hospital. The study included a convenience sample of all available bedside/ working nurses (n= 30), 79 preterm infant (recruited for 3 months' period). Tools: Three tools were used to collect data. Tool 1: An interview questionnaire for nurse's knowledge. Tool 2: Observational checklist used to assess nurses' performance regarding CVL care bundle. Tool 3: Laboratory investigations tool for preterm infants. Results: More than half of studied nurses (56.7%) didn't receive any training program about CVL care bundle for controlling CVL infection in NICU and the majority of the studied nurses had insufficient knowledge, as well as the majority of the studied nurses, had an unsatisfactory practice regarding CVL care bundle preprogram. The sufficient knowledge level and satisfactory practices had improved immediately post and 3 months post program implementation. About half (51,9%) had negative CRP post-program implementation, while (54,4%) of neonates had negative blood culture post-program. Conclusion:The program had a positive effect on the NICU nurses' knowledge & practices immediately post& post 3 months of the program implementation. Recommendation: Including CVL nursing care bundle practices into nurses' routine care and developing regular and continuous educational programs for the nurses in NICU according to their needs aiming to upgrading their knowledge and improving their practice for critically ill neonates.

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CE Article: A Quality Improvement Approach in Standardizing Pediatric Central Venous Catheter Dressings and Its Impact on the Reduction of Central Line-Associated Bloodstream Infections and Costs

Abstract: Highlights A CVC dressing inventory is beneficial to pediatric patients. Dressing standardization reduced unplanned dressing changes and costs. In our study, the new dressing inventory helped reduce the CLABSI rate.

Cited by 3 publications

References 16 publications

Implementation frameworks, strategies and outcomes in optimizing central venous access device practice in paediatrics: A scoping review

Implementation frameworks, strategies and outcomes in optimizing central venous access device practice in paediatrics: A scoping review

Metodologías Lean en salud. Propuesta de mapa analítico-conceptual para sistematizar su impacto y resultados

The Effect of Applying Nursing Care Bundle on Controlling Central Venous Line Infection in Neonatal Intensive Care Units

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