CENTRAL LINE-ASSOCIATED BLOODSTREAM INFECTIONS IN PEDIATRIC HEMATOLOGY UNITS IN GREECE 2016-2018 - IMPACT OF AN INTERVENTION BUNDLE
I. Kopsidas, G. Tsopela , N. Molocha , D. Doganis , K. Kaisari , K. Katsibardi , E. Papakonstantinou , L. Petrikkos , M. Vousvouki , S. Maistreli , E. Kourkouni , T. Zaoutis
37th Annual Meeting of the European Society for Paediatric Infectious Diseases (ESPID 2019)
Ljubljana, Slovenia, 6-11 May, 2019
BACKGROUND: Healthcare-associated infections (HAI) are associated with increased morbidity and mortality and excess costs. Central line-associated bloodstream infections (CLABSIs) are the most common serious HAIs in neonates and children. The broad objectives of this study were to develop a CLABSI collaborative in pediatric oncology units in Greece and to implement an intervention to decrease CLABSI rates.
METHODS: Active surveillance for CLABSIs was conducted from June 2016 to June 2018 in six pediatric hematology oncology units (ONCs). Definitions of central line (CL), central line utilization (CLU) ratio, CLABSI event, and CLABSI rate based on the Centers for Disease Control and Preventions’ National Healthcare Safety Network criteria from 2014. An intervention that included a care bundle for the insertion and maintenance of the central line, with on-site training and educational material posted in the unit environment, was implemented in March and April 2018.
RESULTS: In four units, there was a ≥10% decrease in CLABSI rates, with an increase ≥10% in only one unit. Post-intervention CLABSI rates had a median of 1.88 (IQR:0.75-2.5) compared to 2.48 (IQR:1.40-3.90) pre-intervention (Table 1). The majority of the CLABSIs occurred more than seven days after the placement of the central line in both periods (97.1% pre-intervention and 100% post-intervention).
CONCLUSIONS: An intervention in the form of a care bundle for the insertion and maintenance of central lines implemented in pediatric hematology oncology units in Greece led to a significant decrease in CLABSI rates. The experience gained and the material created can be used in other unit types across hospitals and countries.