viernes, 6 de marzo de 2015

Preventing CLABSIs among pediatric hematology/oncology inpatients: ... - PubMed - NCBI

Preventing CLABSIs among pediatric hematology/oncology inpatients: ... - PubMed - NCBI

 2014 Dec;134(6):e1678-85. doi: 10.1542/peds.2014-0582. Epub 2014 Nov 17.

Preventing CLABSIs among pediatric hematology/oncology inpatients: national collaborative results.



Central lines (CLs) are essential for the delivery of modern cancer care to children. Nonetheless, CLs are subject to potentially life-threatening complications, including central line-associated bloodstream infections (CLABSIs). The objective of this study was to assess the feasibility of a multicenter effort to standardize CL care and CLABSI tracking, and to quantify the impact of standardizing these processes on CLABSI rates among pediatric hematology/oncology inpatients.


We conducted a multicenter quality improvement collaborative starting in November 2009. Multidisciplinary teams at participating sites implemented a standardized bundle of CL care practices and adopted a common approach to CLABSI surveillance.


Thirty-two units participated in the collaborative and reported a mean, precollaborative CLABSI rate of 2.85 CLABSIs per 1000 CL-days. Self-reported adoption of the CL care bundle was brisk, with average compliance approaching 80% by the end of the first year of the collaborative and exceeding 80% thereafter. As of August 2012, the mean CLABSI rate during the collaborative was 2.04 CLABSIs per 1000 CL-days, a reduction of 28% (relative risk: 0.71 [95% confidence interval: 0.55-0.92]). Changes in self-reported CL care bundle compliance were not statistically associated with changes in CLABSI rates, although there was little variability in bundle compliance rates after the first year of the collaborative.


A multicenter quality improvement collaborative found significant reductions in observed CLABSI rates in pediatric hematology/oncology inpatients. Additional interventions will likely be required to bring and sustain CLABSI rates closer to zero for this high-risk population.
Copyright © 2014 by the American Academy of Pediatrics.


bacteremia; catheter-related infections; cross infection; hospital oncology service; quality improvement

[PubMed - indexed for MEDLINE]

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