Compliance With Central Line Maintenance Bundle and Infection Rates

Tripathi, Sandeep; McGarvey, Jeremy S; Lee, Kejin; Staubach, Katherine; Gehring, Emily; Sisson, Patricia; McCaskey, Marjorie; Mack, Elizabeth H.; Hord, Jeffrey D.; Pallotto, Eugenia K.; Lyren, Anne; Coffey, Maitreya

doi:10.1542/peds.2022-059688

Cited by 5 publications

(1 citation statement)

References 13 publications

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“…Perhaps information obtained from audits of CLABSI prevention bundle compliance should be used to drive this education. A recent review of 10 years of data from a hospital system found a significant negative correlation between CLABSI prevention bundle compliance and CLABSI rates ( P < .001) 14…”

Section: Discussionmentioning

confidence: 99%

Vascular Access Team Central Line Dressing Changes to Reduce Infection Risk

Draper,

Nelson,

Taylor

et al. 2024

Journal of Infusion Nursing

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Due to low compliance by bedside nursing with a central line-associated bloodstream infection (CLABSI) prevention bundle and increased CLABSI rates, a mandatory re-education initiative at a 1200-bed university-affiliated hospital was undertaken. Despite this, 2 units, housing high-risk immunocompromised patients, continued to experience increased CLABSI rates. A quality improvement before-after project design in these units replaced bedside nursing staff with 2 nurses from the vascular access team (VAT) to perform central vascular access device (CVAD) dressing changes routinely every 7 days or earlier if needed. The VAT consistently followed the bundled components, including use of chlorhexidine gluconate (CHG)-impregnated dressings on all patients unless an allergy was identified. In this case, a non-CHG transparent semipermeable membrane dressing was used. There were 884 patients with 14 211 CVAD days in the preimplementation period and 1136 patients with 14 225 CVAD days during the postimplementation period. The VAT saw 602 (53.0%) of the 1136 patients, performing at least 1 dressing change in 98% of the patients (n = 589). The combined CLABSI rate for the 2 units decreased from 2.53 per 1000 CVAD days preintervention to 1.62 per 1000 CVAD days postintervention. The estimated incidence rate ratio (IRR) for the intervention was 0.639, a 36.1% reduction in monthly CLABSI rates during the postimplementation period.

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Section: Discussionmentioning

confidence: 99%

Vascular Access Team Central Line Dressing Changes to Reduce Infection Risk

Draper,

Nelson,

Taylor

et al. 2024

Journal of Infusion Nursing

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Journey to STEEEP healthcare: A focus on systems through a patient's experience

Mangum

2023

Current Problems in Pediatric and Adolescent Health Care

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Risk factors for central line-associated bloodstream infection in the pediatric intensive care setting despite standard prevention measures

Marks,

Rosengard,

Franks

et al. 2024

Infect. Control Hosp. Epidemiol.

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Objective: Identify risk factors for central line-associated bloodstream infections (CLABSI) in pediatric intensive care settings in an era with high focus on prevention measures. Design: Matched, case–control study. Setting: Quaternary children’s hospital. Patients: Cases had a CLABSI during an intensive care unit (ICU) stay between January 1, 2015 and December 31, 2020. Controls were matched 4:1 by ICU and admission date and did not develop a CLABSI. Methods: Multivariable, mixed-effects logistic regression. Results: 129 cases were matched to 516 controls. Central venous catheter (CVC) maintenance bundle compliance was >70%. Independent CLABSI risk factors included administration of continuous non-opioid sedative (adjusted odds ratio (aOR) 2.96, 95% CI [1.16, 7.52], P = 0.023), number of days with one or more CVC in place (aOR 1.42 per 10 days [1.16, 1.74], P = 0.001), and the combination of a chronic CVC with administration of parenteral nutrition (aOR 4.82 [1.38, 16.9], P = 0.014). Variables independently associated with lower odds of CLABSI included CVC location in an upper extremity (aOR 0.16 [0.05, 0.55], P = 0.004); non-tunneled CVC (aOR 0.17 [0.04, 0.63], P = 0.008); presence of an endotracheal tube (aOR 0.21 [0.08, 0.6], P = 0.004), Foley catheter (aOR 0.3 [0.13, 0.68], P = 0.004); transport to radiology (aOR 0.31 [0.1, 0.94], P = 0.039); continuous neuromuscular blockade (aOR 0.29 [0.1, 0.86], P = 0.025); and administration of histamine H2 blocking medications (aOR 0.17 [0.06, 0.48], P = 0.001). Conclusions: Pediatric intensive care patients with chronic CVCs receiving parenteral nutrition, those on non-opioid sedative infusions, and those with more central line days are at increased risk for CLABSI despite current prevention measures.

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Compliance With Central Line Maintenance Bundle and Infection Rates

Cited by 5 publications

References 13 publications

Vascular Access Team Central Line Dressing Changes to Reduce Infection Risk

Vascular Access Team Central Line Dressing Changes to Reduce Infection Risk

Journey to STEEEP healthcare: A focus on systems through a patient's experience

Risk factors for central line-associated bloodstream infection in the pediatric intensive care setting despite standard prevention measures

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