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KMID : 1161220210640030123
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Clinical and Experimental Pediatrics
2021 Volume.64 No. 3 p.123 ~ p.129
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Can central venous access device care bundles and regular feedback reduce central line-associated complications in pediatric patients?
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Chaiyakulsil Chanapai
Pharadornuwat Onsuthi
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Abstract
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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.
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KEYWORD
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Patient care bundles, Central line infection, Occlusion, Pediatrics, Prevention
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