Aiming to eliminate central line-associated blood stream infections in hospitalized children, The Steven and Alexandra Cohen Children’s Medical Center of New York’s Pediatric Intensive Care Unit and Bone Marrow Transplant Unit recently marked 452 days and two plus years without an infection.
In collaboration with more than 80 other children’s hospitals nationwide, Cohen Children’s Medical Center’s participation in the National Association of Children’s Hospitals and Related Institutions Quality Transformation Network has saved 355 children’s lives, prevented 2,964 central line infections and passed the $100 million mark for total cost savings.
Central line-associated blood stream infections are infections that occur in patients’ central venous catheters (a central line is flexible medical tubing inserted into the body). They are a preventable occurrence that costs at least $25,000-$45,000 per patient and a 10 percent to 20 percent mortality risk for children.
The change in treatment has been to only use catheters in patients that really need it, taking them out when not needed, or not putting them in for medication purposes at all, according to Dr. Peter Silver, chief of critical care medicine at Cohen Children’s Medical Center.
“In the old school of thought, our feeling was that we could leave these central venal catheters or urinary catheters in forever. Sooner or later, they might get infected, but infection were just part of being in a hospital,” Silver said. “We don’t accept that anymore. It’s just a complete reversal of the way that we were thinking.”
Prior to joining the collaborative effort , the incidence of infection in the Cohen Children’s Medical Center Pediatric Intensive Care Unit was one infection every 28.5 days. Since joining, the incidence has decreased to one infection every 80 days, Silver said. He noted the infections typically dictate a hospital stay of seven to 10 days for antibiotic treatments.
With 162 units from 88 hospitals, 40 percent of the National Association of Children’s Hospitals and Related Institutions Quality Transformation Network of 220 member hospitals have participated to date in this national effort to eradicate pediatric blood-stream infections as well as other health care associated infections.
In adult intensive care, central line-associated blood stream infections have been significantly decreased through a multi-faceted intervention. Previously, the efficacy of the adult intervention in pediatric patients was unknown.
National Association of Children’s Hospitals and Related Institutions Quality Transformation Network hospitals have learned that reducing the incidence of central line-associated blood stream infections events requires an approach combining evidence-based guidelines for catheter insertion with daily maintenance care for central lines.
Reach reporter Richard Tedesco by e-mail at rtedesco@theislandnow.com or by phone at 516.307.1045 x204
