Evaluation of utilizing a central line bundle to decrease catheter-associated bloodstream infections in the pediatric ICU of a large Midwest children's hospital

More than fifty percent of all patients admitted to the intensive care unit will acquire a central venous catheter (CVC) in order to provide a more efficient treatment plan. While very beneficial for treatment, they often come with significant costs that include high bloodstream infection rates, increased mortality rates, increased lengths of stay, and increased cost of additional resources. With quality of care initiatives leading the industry, decreasing catheter-associated bloodstream infections (CA-BSI) has become one focus for improvement. Research shows improvement in adult populations however, few research reports address implementation of the recommendations among pediatric populations. The National Association of Children's Hospitals and Related Institutions (NACHRI) group called upon pediatric institutions to develop a standard of care for central line maintenance to reduce infection rates. This secondary analysis investigated the effects of a central line bundle on reducing CA-BSI in a pediatric intensive care unit (PICU). The conceptual framework was based on The Improvement Model developed by Langley et al. (1996) to test and evaluate new changes. Based on data collected from one PICU's performance improvement practices and for the NACHRI collaborative, this study evaluated rates of infection before and after the collaborative as well as nursing compliance with the bundle. Data was not statistically significant during the initiation year of implementation, however, the first complete year after initiation showed statistically significant results. Nursing compliance with the bundle was variable across the years and with each bundle element. Further research is recommended as improving CA-BSI rates impact pediatric patient outcomes.