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Bloodstream Infections in Kids Significantly Reduced With Quality Improvement Initiatives

Monday, May 03, 2010

Bloodstream infections associated with catheters can be significantly reduced through quality improvement efforts, possibly leading to better health outcomes and lives saved, decreased stays at the hospital and related costs, according to a new study.

The Cincinnati Children’s Hospital Medical Center study shows that a project to reduce catheter-associated bloodstream infections in cardiac intensive care units reduced their incidence from a baseline of 3.3 per 1,000 central line days to 0.55 per 1,000 central line days at the end of the intervention period.

“We were able to reduce the incidence of bloodstream infections after implementing a central line insertion and maintenance bundle,” said Derek S. Wheeler, M.D., a critical care physician at Cincinnati Children’s and the study’s lead author. “This bundle emphasizes full sterile barrier precautions and chlorhexidine skin preparation during insertion, as well as daily discussion of catheter necessity and meticulous site and tubing care.”

The study will be presented at 7 p.m. ET Monday, May 3 at the annual Pediatric Academic Societies (PAS) meeting in Vancouver, Canada.

The study is one of two presented by Dr. Wheeler and colleagues this year at PAS that deal with catheter-associated bloodstream infections. The second study shows that a hospital-wide quality improvement collaborative resulted in a significant reduction in the incidence rate, from a baseline of 3.0 per 1,000 line days to less than 1.0 per 1,000 line days.

The collaborative approach included hospital-wide implementation of the same central line insertion and maintenance bundle on three critical care units, one oncology unit, one bone marrow transplant unit, and general medical/surgical units.

Catheter-associated bloodstream infections (CA-BSI) comprise the vast majority of hospital-acquired BSI in pediatric patients and are associated with increased length of stay (LOS), hospital costs and mortality.

Dr. Wheeler conducted the study in collaboration with researchers from Nationwide Children’s Hospital in Columbus, Ohio.

About Cincinnati Children’s

Cincinnati Children’s Hospital Medical Center is one of 10 children’s hospitals named to the Honor Roll in U.S. News and World Report’s 2009 America’s Best Children’s Hospitals and is one of 8 children’s hospitals named to the Leapfrog Group’s 2009 list of Top Children’s Hospitals. Through U.S. News they are ranked #1 for digestive disorders and are also highly ranked for their expertise in respiratory diseases, cancer, neonatal care, heart care, neurology and neurosurgery, diabetes, orthopedics, kidney disorders and urology. Cincinnati Children’s is one of the top two recipients of pediatric research grants from the National Institutes of Health (NIH). Internationally recognized for quality and innovation by The Joint Commission, the Institute for Healthcare Improvement and the federal Agency for Healthcare Research and Quality, it has collaborations with hospitals and health systems around the world. Additional information can be found at www.cincinnatichildrens.org