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Eliminating Central Line Associated Bloodstream Infections in Pediatric Oncology Patients: A Quality Improvement Effort
Central Line-Associated Bloodstream Infections (CLABSI) are the largest contributor to harm across the Children’s Hospital’s Solutions for Patient Safety network. Pediatric hematology/oncology (PHO) patients are at increased risk for CLABSI due to multiple factors. Consequently, traditional CLABSI p...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Lippincott Williams & Wilkins
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10219729/ https://www.ncbi.nlm.nih.gov/pubmed/37250614 http://dx.doi.org/10.1097/pq9.0000000000000660 |
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author | Willis, Daniel N. Looper, Karen Malone, Rema A. Ricken, Barbara Slater, Ashley Fuller, Amanda McCaughey, Meagan Niesen, Angela Smith, Joan R. Brozanski, Beverly |
author_facet | Willis, Daniel N. Looper, Karen Malone, Rema A. Ricken, Barbara Slater, Ashley Fuller, Amanda McCaughey, Meagan Niesen, Angela Smith, Joan R. Brozanski, Beverly |
author_sort | Willis, Daniel N. |
collection | PubMed |
description | Central Line-Associated Bloodstream Infections (CLABSI) are the largest contributor to harm across the Children’s Hospital’s Solutions for Patient Safety network. Pediatric hematology/oncology (PHO) patients are at increased risk for CLABSI due to multiple factors. Consequently, traditional CLABSI prevention strategies are insufficient to eliminate CLABSI in this high-risk population. METHODS: Our SMART aim was to reduce the CLABSI rate by 50% from a baseline of 1.89/1000 central line days to less than 0.9/1000 central line days by December 31, 2021. We created a multidisciplinary team being mindful to identify roles and responsibilities upfront. We developed a key driver diagram and designed and implemented interventions to influence our primary outcome. RESULTS: We implemented interventions and conducted Plan-Do-Study-Act cycles concurrently. We found that performing audits by directly observing tasks rather than auditing documentation resulted in more accurate compliance assessments. As a result, our CLABSI rate improved from 1.89/1000 central line days in 2020 with 11 primary CLABSI to 0.73/1000 central line days in 2021 with four primary CLABSI. Average days between events improved from 30 days in 2020 to 73 days in 2021, and we achieved an unprecedented 542 days CLABSI-free, extending into 2022. CONCLUSIONS: Through a multimodal approach and utilizing characteristics of high-reliability organizations, we significantly reduced primary CLABSI, approaching zero in our PHO population and doubling the average days between events. Future efforts will focus on the sustained engagement of all stakeholders and improving our safety culture. |
format | Online Article Text |
id | pubmed-10219729 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Lippincott Williams & Wilkins |
record_format | MEDLINE/PubMed |
spelling | pubmed-102197292023-05-29 Eliminating Central Line Associated Bloodstream Infections in Pediatric Oncology Patients: A Quality Improvement Effort Willis, Daniel N. Looper, Karen Malone, Rema A. Ricken, Barbara Slater, Ashley Fuller, Amanda McCaughey, Meagan Niesen, Angela Smith, Joan R. Brozanski, Beverly Pediatr Qual Saf Individual QI projects from single institutions Central Line-Associated Bloodstream Infections (CLABSI) are the largest contributor to harm across the Children’s Hospital’s Solutions for Patient Safety network. Pediatric hematology/oncology (PHO) patients are at increased risk for CLABSI due to multiple factors. Consequently, traditional CLABSI prevention strategies are insufficient to eliminate CLABSI in this high-risk population. METHODS: Our SMART aim was to reduce the CLABSI rate by 50% from a baseline of 1.89/1000 central line days to less than 0.9/1000 central line days by December 31, 2021. We created a multidisciplinary team being mindful to identify roles and responsibilities upfront. We developed a key driver diagram and designed and implemented interventions to influence our primary outcome. RESULTS: We implemented interventions and conducted Plan-Do-Study-Act cycles concurrently. We found that performing audits by directly observing tasks rather than auditing documentation resulted in more accurate compliance assessments. As a result, our CLABSI rate improved from 1.89/1000 central line days in 2020 with 11 primary CLABSI to 0.73/1000 central line days in 2021 with four primary CLABSI. Average days between events improved from 30 days in 2020 to 73 days in 2021, and we achieved an unprecedented 542 days CLABSI-free, extending into 2022. CONCLUSIONS: Through a multimodal approach and utilizing characteristics of high-reliability organizations, we significantly reduced primary CLABSI, approaching zero in our PHO population and doubling the average days between events. Future efforts will focus on the sustained engagement of all stakeholders and improving our safety culture. Lippincott Williams & Wilkins 2023-05-29 /pmc/articles/PMC10219729/ /pubmed/37250614 http://dx.doi.org/10.1097/pq9.0000000000000660 Text en Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY (https://creativecommons.org/licenses/by/4.0/) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Individual QI projects from single institutions Willis, Daniel N. Looper, Karen Malone, Rema A. Ricken, Barbara Slater, Ashley Fuller, Amanda McCaughey, Meagan Niesen, Angela Smith, Joan R. Brozanski, Beverly Eliminating Central Line Associated Bloodstream Infections in Pediatric Oncology Patients: A Quality Improvement Effort |
title | Eliminating Central Line Associated Bloodstream Infections in Pediatric Oncology Patients: A Quality Improvement Effort |
title_full | Eliminating Central Line Associated Bloodstream Infections in Pediatric Oncology Patients: A Quality Improvement Effort |
title_fullStr | Eliminating Central Line Associated Bloodstream Infections in Pediatric Oncology Patients: A Quality Improvement Effort |
title_full_unstemmed | Eliminating Central Line Associated Bloodstream Infections in Pediatric Oncology Patients: A Quality Improvement Effort |
title_short | Eliminating Central Line Associated Bloodstream Infections in Pediatric Oncology Patients: A Quality Improvement Effort |
title_sort | eliminating central line associated bloodstream infections in pediatric oncology patients: a quality improvement effort |
topic | Individual QI projects from single institutions |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10219729/ https://www.ncbi.nlm.nih.gov/pubmed/37250614 http://dx.doi.org/10.1097/pq9.0000000000000660 |
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