Navigation Links
'Triple-threat' approach reduces life-threatening central line infections in children with cancer
Date:9/2/2012

Hospitals can dramatically reduce the number of life-threatening central line infections in pediatric cancer patients by following a set of basic precautions, by encouraging families to speak up when they observe noncompliance with the protocol and by honest analysis of the root cause behind every single infection, according to a new Johns Hopkins Children's Center study.

In a report in the October issue of Pediatrics, published online Sept. 3, the researchers say this triple-threat approach has prevented one in five infections over two years.

Previous studies from Johns Hopkins and other institutions have demonstrated that meticulous daily care of the central line can cut the number of bloodstream infections in critically ill patients, but this is the first study, the researchers say, to focus on the most vulnerable of pediatric patients - those undergoing cancer treatment and bone marrow transplants.

A central venous catheter, or central line, is a tube inserted into a major blood vessel in the neck, chest or groin as a portal for medication, fluids or blood draws.

Inserted incorrectly or mishandled after insertion, the central line can become a gateway for bacteria and other germs into the patient's bloodstream, causing invasive disease and organ damage. Because nurses and doctors access the catheter several times a day -- as much as 10 to 30 times daily in oncology patients, researchers say -- proper handling of the device is critical.

"Children receiving cancer treatment are uniquely prone to invasive bloodstream infections because of their weakened immunity and because their central lines are accessed multiple times a day, with each entry posing a risk for infection," says lead investigator Michael Rinke, M.D., a pediatrician and a patient safety expert at the Johns Hopkins Children's Center.

The current study was carried out by pediatric oncology nurses, physicians and safety experts at the Johns Hopkins pediatric inpatient cancer unit. To keep bacteria and other pathogens at bay, the nurses deployed strict device-handling precautions that included -- among other things -- frequent and regular changing of the dressing covering the central line; regular changing of the tubes and caps attached to central line; cleaning of the line before and after each use; use of facial mask and gloves when handling the device; and hand-washing before and after handling the line.

In a novel twist, the Johns Hopkins investigators asked parents to provide additional oversight, equipping them with wallet flash cards on the "do's" and "don'ts" of central line care.

"Parents can act as an invaluable second set of eyes, and we urged them to be vigilant about the way their child's central line was handled." says co-investigator Kim Drucis, M.S.N., R.N., a pediatric oncology nurse. "We also encouraged them to ask questions and to speak up every time they noticed something different."

The oncology nurses also held monthly briefings to discuss every infection that occurred during the study. Such root-cause analysis is already a staple of error reduction in other industries including airline, nuclear and military.

"Honest dissection of one's practice is neither easy nor pleasant but is absolutely critical to illuminate areas for improvement," says co-investigator Stephanie Panton, M.S.N., R.N., C.P.O.N.

The approach reduced infections by 20 percent over two years. During year one, the infection rate remained unchanged but in the second year, infections plummeted by 64 percent -- a delayed ramp-up effect that points to the often-slow pace of meaningful change, the investigators say.

"Real change rarely occurs overnight. It requires sustained effort and unwavering focus, day after day, month after month, year after year," Rinke says. "It's a slow, arduous process, but the payoff can be dramatic."

Each year, 250,000 central line infections occur in the United States, up to one-fourth of them fatal, according to the Centers for Disease Control and Prevention. Each infection carries a price tag of up to $25,000.


'/>"/>

Contact: Ekaterina Pesheva
epeshev1@jhmi.edu
410-502-9433
Johns Hopkins Medicine
Source:Eurekalert

Related medicine news :

1. Unique approach needed to accurately assess health of young adult cancer survivors
2. MU receives national award for using mind-body approach to improve health
3. Global, common approach to pharmaceutical supply chain integrity the focus of workshop
4. Editorial calls for comprehensive approach to cancer screening
5. Rutgers team discovers novel approach to stimulate immune cells
6. National initiative launched to change the way biology departments approach undergraduate education
7. A systems approach to preventing obesity in early life
8. Mount Sinai researchers develop a multi-target approach to treating tumors
9. Moffitt researcher, colleagues find success with new immune approach to fighting some cancers
10. A non-antibiotic approach for treating urinary tract infections
11. SingleSource Background Screening Company Calls On Adults To Take Proactive Approach To Stop Child Sexual Abuse
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/27/2016)... ... June 27, 2016 , ... ... technology to revolutionize the emergency ambulance transport experience for the millions of people ... how Uber has disrupted the taxi industry through the use of technology. Now, ...
(Date:6/26/2016)... ... 2016 , ... Pixel Film Studios Released ProSlice Levels, a Media Slicing Effect ... videos a whole new perspective by using the title layers in ProSlice Levels ... , ProSlice Levels contains over 30 Different presets to choose from. FCPX ...
(Date:6/25/2016)... ... June 25, 2016 , ... ... issues and applications at AcademyHealth’s Annual Research Meeting June 26-28, 2016, at the ... several important health care topics including advance care planning, healthcare costs and patient ...
(Date:6/25/2016)... ... ... First Choice Emergency Room , the largest network of independent freestanding ... of its new Mesquite-Samuell Farm facility. , “We are pleased to announce Dr. ... James M. Muzzarelli, Executive Medical Director of First Choice Emergency Room. , Dr. ...
(Date:6/25/2016)... ... June 25, 2016 , ... Conventional wisdom preaches the benefits ... terms of the latter, setting the bar too high can result in disappointment, perhaps ... slow progress toward their goal. , Research from PsychTests.com reveals that ...
Breaking Medicine News(10 mins):
(Date:6/24/2016)... Belgium , June 24, 2016 ... today announced the appointment of Dr. Edward ... as a Non-Executive Director, effective June 23, 2016.Dr. ... Compensation and Nominations and Governance Committees.  As a ... will provide independent expertise and strategic counsel to ...
(Date:6/23/2016)... 23, 2016 Research and Markets ... Market by Type (Organic Chemical (Sugar, Petrochemical, Glycerin), Inorganic ... Coating, Parenteral) - Global Forecast to 2021" report ... The global pharmaceutical excipients market is projected to ... of 6.1% in the forecast period 2016 to 2021. ...
(Date:6/23/2016)... 23, 2016 Research and Markets has ... 52" report to their offering. ... creates a favourable commercial environment for MedImmune to enter. The ... that will serve to drive considerable growth for effective anti-influenza ... to cap sales considerably, but development is still in its ...
Breaking Medicine Technology: