Gauntt Jennifer, Brandt Sarah, Dolan Kevin, Manley Jaime, Tyner Roxann, Beauseau Wendi, Simsic Janet M
The Heart Center at Nationwide Children's Hospital, Columbus, Ohio.
Center for Clinical Excellence at Nationwide Children's Hospital, Columbus, Ohio.
Pediatr Qual Saf. 2022 Jun 23;7(4):e575. doi: 10.1097/pq9.0000000000000575. eCollection 2022 Jul-Aug.
Central line-associated bloodstream infections (CLABSIs) are preventable events that increase morbidity and mortality. The objective of this quality project was to reduce the incidence of CLABSIs in a pediatric cardiothoracic intensive care unit.
Institutional review of an unacceptably high rate of CLABSIs led to the implementation of 4 new interventions. These interventions included: the use of sequential cleaning between line accesses, Kamishibai card audits, central line utilization and entry audits, and proctored simulation of line access.
There was a reduction in CLABSI rate from 1.52 per 1,000 central line days in 2018 to 0.37 per 1,000 central line days in 2020 and 0.32 in 2021. Additionally, central line days per 100 patient days decreased from 77 to 70 days over the study period. The cardiothoracic intensive care unit went 389 days without a CLABSI from October 2020 to November 2021.
Implementation of multiple interventions led to a successful reduction in the incidence of CLABSIs in our unit, with a sustained reduction over 1 year.
中心静脉导管相关血流感染（CLABSI）是可预防的事件，会增加发病率和死亡率。本质量改进项目的目标是降低小儿心胸重症监护病房中CLABSI的发生率。
对CLABSI发生率高得令人无法接受的情况进行机构审查后，实施了4项新的干预措施。这些干预措施包括：在每次使用导管之间采用序贯清洁法、使用卡片式检查表进行审核、对中心静脉导管的使用和置入情况进行审核，以及对导管置入操作进行监考模拟。
CLABSI发生率从2018年的每1000个中心静脉导管日1.52例降至2020年的每1000个中心静脉导管日0.37例，2021年为0.32例。此外，在研究期间，每100个患者日的中心静脉导管使用天数从77天降至70天。从2020年10月到2021年11月，心胸重症监护病房连续389天无CLABSI发生。
实施多项干预措施使我们科室的CLABSI发生率成功降低，并在1年多的时间里持续下降。
