Prevention of CAUTIs, CLABSIs, and VAPs in Children

Mack, Elizabeth H.; Stem, Christopher

doi:10.1007/s40746-017-0094-8

Cited by 6 publications

(2 citation statements)

References 58 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Some of the most established pediatric HAC prevention bundles include health care-acquired infections. Various organizations have published slight variations in the catheter-associated urinary tract infection (27)(28)(29), ventilator-associated pneumonia (27,(30)(31)(32), and central line-associated bloodstream infection bundles (27,(33)(34)(35)(36). SPS also has established published prevention bundles for the following HACs: falls, pressure injuries, readmissions, surgical site infections, and venous thromboembolism (27).…”

Section: Health Care Acquired Condition Preventionmentioning

confidence: 99%

Making care better in the pediatric intensive care unit

Wolfe¹,

Mack²

2018

Transl Pediatr

Self Cite

View full text Add to dashboard Cite

The relatively young field of pediatric critical care has seen a shift from an approach with little consideration for the complications and adverse effects resulting from the procedures and medications to a more cautious approach with careful concern for the associated risks. Many senior pediatric intensivists recall a time when nearly every patient had a central venous line and arterial line; and hospital acquired infections, pressure injuries, unplanned extubations, and venous thromboemboli were expected costs of aggressive care. In addition to the morbidity and mortality associated with many of the health care-acquired conditions (HACs) in children, the attributable cost due to these HACs contributes to the unsustainable health care financial crisis. The Centers for Medicare and Medicaid Services (CMS) often penalize hospitals for HACs, and also are beginning to reimburse in a bundled fashion such that complications become the institution's burden. In children, payors and patients' families are often saddling this burden of costs attributable to HACs. The direct attributable costs per event are staggering. Payors, families, patients, and health care teams now demand a circumspect approach to care: do no harm, but how?

show abstract

Section: Health Care Acquired Condition Preventionmentioning

confidence: 99%

Making care better in the pediatric intensive care unit

Wolfe¹,

Mack²

2018

Transl Pediatr

Self Cite

View full text Add to dashboard Cite

show abstract

“… 3 – 5 In pediatrics, Children’s Hospitals’ Solutions for Patient Safety (SPS) CLABSI bundle, guidelines followed by over 135 children’s hospitals, has also been shown to reduce CLABSI rates across network hospitals. 6 Adequate disinfection of the catheter hub before line entry to prevent intraluminal contamination is a key component of the central line maintenance bundle. 7 Suitable disinfection can be achieved by scrubbing the hub for a predetermined time (10–20 s) followed by a specified drying time before and after each line entry.…”

Section: Introductionmentioning

confidence: 99%

Sustaining Improvements in CLABSI Reduction in a Pediatric Cardiac Intensive Care Unit

Gauntt

Brandt

Dolan

et al. 2022

Pediatric Quality &Amp; Safety

View full text Add to dashboard Cite

Introduction: Central line-associated bloodstream infections (CLABSIs) are preventable events that increase morbidity and mortality. The objective of this quality project was to reduce the incidence of CLABSIs in a pediatric cardiothoracic intensive care unit. Methods: Institutional review of an unacceptably high rate of CLABSIs led to the implementation of 4 new interventions. These interventions included: the use of sequential cleaning between line accesses, Kamishibai card audits, central line utilization and entry audits, and proctored simulation of line access. Results: There was a reduction in CLABSI rate from 1.52 per 1,000 central line days in 2018 to 0.37 per 1,000 central line days in 2020 and 0.32 in 2021. Additionally, central line days per 100 patient days decreased from 77 to 70 days over the study period. The cardiothoracic intensive care unit went 389 days without a CLABSI from October 2020 to November 2021. Conclusions: Implementation of multiple interventions led to a successful reduction in the incidence of CLABSIs in our unit, with a sustained reduction over 1 year.

show abstract