Can central venous access device care bundles and regular feedback reduce central line-associated complications in pediatric patients?
Background The use of indwelling central venous access devices (CVADs) in children can result in complications such as infection, occlusion, and dislodgement. Purpose To evaluate whether reinforcing CVAD care bundles by using a regular direct feedback system could reduce such complications in childr...
| Main Authors: | , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
The Korean Pediatric Society
2021-03-01
|
| Series: | Clinical and Experimental Pediatrics |
| Subjects: | |
| Online Access: | http://www.e-cep.org/upload/pdf/cep-2020-00143.pdf |
| _version_ | 1818849270089908224 |
|---|---|
| author | Chanapai Chaiyakulsil Onsuthi Pharadornuwat |
| author_facet | Chanapai Chaiyakulsil Onsuthi Pharadornuwat |
| author_sort | Chanapai Chaiyakulsil |
| collection | DOAJ |
| description | Background The use of indwelling central venous access devices (CVADs) in children can result in complications such as infection, occlusion, and dislodgement. Purpose To evaluate whether reinforcing CVAD care bundles by using a regular direct feedback system could reduce such complications in children. Methods The intervention in this retrospective interrupted time-series study was initiated in January 2019. The study was divided into the preintervention (October–December 2018), 3-month postintervention (January–March 2019), and 6-month postintervention (April–June 2019) phases. Risk difference and Poisson regression analyses were used to illustrate the effectiveness of the intervention. Results The hospital-wide central line-related bloodstream infection rate decreased from 10.0/1,000 catheter-days to 4.5/1,000 catheter-days at 3-month postintervention (P=0.39) and to 1.4/1,000 catheter-days at 6-month postintervention (P=0.047). The central line occlusion rate significantly decreased from 30% to 12.8% (P=0.04) and 8.3% (P=0.002) at 3 and 6 months, respectively. Approximately 7% of CVADs became dislodged during the preintervention phase versus 8.5% (P=0.364) and 3.3% (P=0.378) at 3 and 6 months, respectively. Conclusion Reinforcing CVAD care bundles with direct feedback could significantly decrease CVAD-associated complications in terms of infection at 6-month postintervention, and occlusion at 3- and 6-month postintervention. Thus, reinforcement and regular direct feedback might improve care quality in children with CVADs. |
| first_indexed | 2024-12-19T06:30:34Z |
| format | Article |
| id | doaj.art-2750c4a8133d46578aa677b54ac4421a |
| institution | Directory Open Access Journal |
| issn | 2713-4148 |
| language | English |
| last_indexed | 2024-12-19T06:30:34Z |
| publishDate | 2021-03-01 |
| publisher | The Korean Pediatric Society |
| record_format | Article |
| series | Clinical and Experimental Pediatrics |
| spelling | doaj.art-2750c4a8133d46578aa677b54ac4421a2022-12-21T20:32:24ZengThe Korean Pediatric SocietyClinical and Experimental Pediatrics2713-41482021-03-0164312312910.3345/cep.2020.0014320125555417Can central venous access device care bundles and regular feedback reduce central line-associated complications in pediatric patients?Chanapai Chaiyakulsil0Onsuthi Pharadornuwat1 Division of Pediatric Critical Care, Department of Pediatrics, Faculty of Medicine, Thammasat University, Prathumthani, Thailand Division of Pediatric Critical Care, Department of Pediatrics, Faculty of Medicine, Thammasat University, Prathumthani, ThailandBackground The use of indwelling central venous access devices (CVADs) in children can result in complications such as infection, occlusion, and dislodgement. Purpose To evaluate whether reinforcing CVAD care bundles by using a regular direct feedback system could reduce such complications in children. Methods The intervention in this retrospective interrupted time-series study was initiated in January 2019. The study was divided into the preintervention (October–December 2018), 3-month postintervention (January–March 2019), and 6-month postintervention (April–June 2019) phases. Risk difference and Poisson regression analyses were used to illustrate the effectiveness of the intervention. Results The hospital-wide central line-related bloodstream infection rate decreased from 10.0/1,000 catheter-days to 4.5/1,000 catheter-days at 3-month postintervention (P=0.39) and to 1.4/1,000 catheter-days at 6-month postintervention (P=0.047). The central line occlusion rate significantly decreased from 30% to 12.8% (P=0.04) and 8.3% (P=0.002) at 3 and 6 months, respectively. Approximately 7% of CVADs became dislodged during the preintervention phase versus 8.5% (P=0.364) and 3.3% (P=0.378) at 3 and 6 months, respectively. Conclusion Reinforcing CVAD care bundles with direct feedback could significantly decrease CVAD-associated complications in terms of infection at 6-month postintervention, and occlusion at 3- and 6-month postintervention. Thus, reinforcement and regular direct feedback might improve care quality in children with CVADs.http://www.e-cep.org/upload/pdf/cep-2020-00143.pdfpatient care bundlescentral line infectionocclusionpediatricsprevention |
| spellingShingle | Chanapai Chaiyakulsil Onsuthi Pharadornuwat Can central venous access device care bundles and regular feedback reduce central line-associated complications in pediatric patients? Clinical and Experimental Pediatrics patient care bundles central line infection occlusion pediatrics prevention |
| title | Can central venous access device care bundles and regular feedback reduce central line-associated complications in pediatric patients? |
| title_full | Can central venous access device care bundles and regular feedback reduce central line-associated complications in pediatric patients? |
| title_fullStr | Can central venous access device care bundles and regular feedback reduce central line-associated complications in pediatric patients? |
| title_full_unstemmed | Can central venous access device care bundles and regular feedback reduce central line-associated complications in pediatric patients? |
| title_short | Can central venous access device care bundles and regular feedback reduce central line-associated complications in pediatric patients? |
| title_sort | can central venous access device care bundles and regular feedback reduce central line associated complications in pediatric patients |
| topic | patient care bundles central line infection occlusion pediatrics prevention |
| url | http://www.e-cep.org/upload/pdf/cep-2020-00143.pdf |
| work_keys_str_mv | AT chanapaichaiyakulsil cancentralvenousaccessdevicecarebundlesandregularfeedbackreducecentrallineassociatedcomplicationsinpediatricpatients AT onsuthipharadornuwat cancentralvenousaccessdevicecarebundlesandregularfeedbackreducecentrallineassociatedcomplicationsinpediatricpatients |