Cut Infection Rate in Half
A long-term central venous catheter is an essential tool for critical pediatric care but introduces a possible complication into the treatment plan. Central line-associated bloodstream infections, CLABSI, occur in about 2 out of every 1,000 catheter-days in children with sickle cell anemia and more frequently in infants with intestinal insufficiency – two common problems that require a central line.
Pathogens such as coagulase-negative staphylococci are often introduced into the body via the catheter hub or during the insertion. At the very least, an infection causes an interruption in the treatment and may require catheter removal, but it can lead to a serious complication such as intravascular thrombosis, endocarditis or sepsis. One children’s hospital is getting proactive about central line infection control and reducing incidents of pediatric CLABSIs by 50 percent.
New Policy at Riley Hospital for Children
The infection prevention specialists at Riley Hospital for Children at Indiana University Health shared the results of a study they did at the 42nd Annual Conference of the Association for Professionals in Infection Control and Epidemiology. The study tested the effectiveness of a new prevention technique designed to reduce the incidents of bloodstream infections for their young patients requiring a central line.
The team there introduced daily bathing of pediatric patients using disposable cloths saturated with 2 percent chlorhexidine gluconate, an antimicrobial able to kill germs on the skin for a prolonged period. Combined with strict adherence to infection prevention protocols, such as clean linens and proper technique for tubing and cap changes, the daily baths decreased the number of CLABSIs by 59 percent – saving the hospital an estimated $300,000 dollars.
During the six-month study period, bathing compliance went from 45 percent to 81 percent and the hospital reported only 22 central line-associated infections. The study authors noted a 56 percent drop methicillin-resistant Staphylococcus aureus infections, as well.
The Next Step
The Centers for Disease Control and Prevention estimates there are 30,100 central line-associated bloodstream infections each year in acute care facilities. Proper insertion techniques and management of the line may not be enough to prevent the introduction of pathogens into the bloodstream. The success of Riley Hospital shows that an addiction preventive measure can have a powerful impact on the number of these types of infections.
For this study, the staff limited the bathing practice to the hematology/oncology unit. In the future, they plan to expand this policy to include other patients. To reduce the risk of cross-contamination, they will initiate a bathing routine using CHG-impregnated wipes for all patients whether they have a central line or not.