Nurse-Driven Interventions Reduce Central Line-Associated Bloodstream Infection Close to Zero in One Pediatric Oncologic Facility: A Single-Center Retrospective Observational Study.

IF 2.4 Q1 NURSING Nursing Reports Pub Date : 2024-09-26 DOI:10.3390/nursrep14040197

Federico Turoldo, Antonella Longo, Mariavittoria Sala, Denis Valentini, Nicole De Vita, Sara Toniutti, Loredana Zuppel, Natalia Maximova

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Abstract

Background: Central line-associated bloodstream infections (CLABSIs) are critical infectious complications among pediatric hematology-oncology patients, and the management of central venous catheters (CVCs) by healthcare personnel can significantly influence the incidence of these infections. This study evaluates the impact of nurse-led changes in CVC management on the incidence of CLABSIs.

Methods: This single-center, retrospective observational study was conducted at an urban, tertiary referral, and academic center serving pediatric patients.

Results: The study cohort comprised 239 patients and 323 CVCs seen between 2012 and 2022. CLABSI was defined according to the Centers for Disease Control and Prevention definitions. Oncology nurse leaders developed CVC-specific educational modules for CLABSI prevention. All the relevant information during the CVC maintenance period was noted in the patient's CVC logbook. A total of 24 (7%) cases of confirmed CLABSI were identified. The incidence of CVC-related infections was 0.32 cases per 1000 catheter days (95%CI: 0.19-0.45). The incidence decreased by 40% between the first and second three-year study period. Documented exit-site infection was reported in 32 (10%) cases. The correlation between exit-site infection and CLABSI was found in 9 (28%) cases. Our CVC-related infection rates are significantly lower than the incidence reported by the Italian Association of Pediatric Hematology and Oncology, which settles at 3-5 cases per 1000 catheter days.

Conclusions: Our data confirm the effectiveness of local CVC management guidelines in preventing CVC-related infectious complications.

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在一家儿科肿瘤医院，护士主导的干预措施将中心管路相关血流感染降至近乎零：单中心回顾性观察研究。

背景：中心静脉导管相关性血流感染（CLABSIs）是儿科血液肿瘤患者的重要感染并发症，而医护人员对中心静脉导管（CVCs）的管理可显著影响这些感染的发生率。本研究评估了护士主导的 CVC 管理变革对 CLABSIs 发生率的影响：这项单中心回顾性观察研究是在一个为儿科患者服务的城市三级转诊学术中心进行的：研究队列包括 2012 年至 2022 年间就诊的 239 名患者和 323 个 CVC。CLABSI是根据美国疾病控制和预防中心的定义界定的。肿瘤科护士长开发了针对 CVC 的预防 CLABSI 教育模块。患者的 CVC 日志中记录了 CVC 维护期间的所有相关信息。共发现 24 例（7%）确诊的 CLABSI 病例。与 CVC 相关的感染发生率为每 1000 个导管日 0.32 例（95%CI：0.19-0.45）。在第一个和第二个三年研究期间，发病率下降了 40%。有记录的出口感染病例为 32 例（10%）。有 9 例（28%）病例发现出口感染与 CLABSI 相关。我们的CVC相关感染率明显低于意大利儿科血液学和肿瘤学协会（Italian Association of Pediatric Hematology and Oncology）报告的发病率，后者的发病率为每1000导管日3-5例：我们的数据证实了当地 CVC 管理指南在预防 CVC 相关感染并发症方面的有效性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Nursing Reports NURSING-

CiteScore

2.50

自引率

4.20%

发文量

期刊介绍： Nursing Reports is an open access, peer-reviewed, online-only journal that aims to influence the art and science of nursing by making rigorously conducted research accessible and understood to the full spectrum of practicing nurses, academics, educators and interested members of the public. The journal represents an exhilarating opportunity to make a unique and significant contribution to nursing and the wider community by addressing topics, theories and issues that concern the whole field of Nursing Science, including research, practice, policy and education. The primary intent of the journal is to present scientifically sound and influential empirical and theoretical studies, critical reviews and open debates to the global community of nurses. Short reports, opinions and insight into the plight of nurses the world-over will provide a voice for those of all cultures, governments and perspectives. The emphasis of Nursing Reports will be on ensuring that the highest quality of evidence and contribution is made available to the greatest number of nurses. Nursing Reports aims to make original, evidence-based, peer-reviewed research available to the global community of nurses and to interested members of the public. In addition, reviews of the literature, open debates on professional issues and short reports from around the world are invited to contribute to our vibrant and dynamic journal. All published work will adhere to the most stringent ethical standards and journalistic principles of fairness, worth and credibility. Our journal publishes Editorials, Original Articles, Review articles, Critical Debates, Short Reports from Around the Globe and Letters to the Editor.