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

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 s...

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Main Authors: Federico Turoldo, Antonella Longo, Mariavittoria Sala, Denis Valentini, Nicole De Vita, Sara Toniutti, Loredana Zuppel, Natalia Maximova
Format: Article
Language:English
Published: MDPI AG 2024-09-01
Series:Nursing Reports
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Online Access:https://www.mdpi.com/2039-4403/14/4/197
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author Federico Turoldo
Antonella Longo
Mariavittoria Sala
Denis Valentini
Nicole De Vita
Sara Toniutti
Loredana Zuppel
Natalia Maximova
author_facet Federico Turoldo
Antonella Longo
Mariavittoria Sala
Denis Valentini
Nicole De Vita
Sara Toniutti
Loredana Zuppel
Natalia Maximova
author_sort Federico Turoldo
collection DOAJ
description 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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spelling doaj-art-77e2ba34de424ee9aa439be776575f982024-12-27T14:44:05ZengMDPI AGNursing Reports2039-439X2039-44032024-09-011442668267910.3390/nursrep14040197Nurse-Driven Interventions Reduce Central Line-Associated Bloodstream Infection Close to Zero in One Pediatric Oncologic Facility: A Single-Center Retrospective Observational StudyFederico Turoldo0Antonella Longo1Mariavittoria Sala2Denis Valentini3Nicole De Vita4Sara Toniutti5Loredana Zuppel6Natalia Maximova7Department of Medicine, Surgery and Health Sciences, Hygiene and Preventive Medicine, University of Trieste, Strada di Fiume 447, 34149 Trieste, ItalyDepartment of Pediatrics, Institute for Maternal and Child Health—IRCCS “Burlo Garofolo”, Via dell’Istria 65/1, 34137 Trieste, ItalyDepartment of Public Health and Pediatric Sciences, University of Turin, 10136 Turin, ItalyDepartment of Emergency Medicine, Hospital of Cattinara, Azienda Sanitaria Universitaria Giuliano Isontina (ASU GI), Strada di Fiume 447, 34149 Trieste, ItalyDepartment of Pediatrics, Institute for Maternal and Child Health—IRCCS “Burlo Garofolo”, Via dell’Istria 65/1, 34137 Trieste, ItalyDepartment of Pediatrics, Institute for Maternal and Child Health—IRCCS “Burlo Garofolo”, Via dell’Istria 65/1, 34137 Trieste, ItalyDepartment of Pediatrics, Institute for Maternal and Child Health—IRCCS “Burlo Garofolo”, Via dell’Istria 65/1, 34137 Trieste, ItalyDepartment of Pediatrics, Institute for Maternal and Child Health—IRCCS “Burlo Garofolo”, Via dell’Istria 65/1, 34137 Trieste, ItalyBackground: 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.https://www.mdpi.com/2039-4403/14/4/197central venous catheterpediatriconcologicalcentral line-associated bloodstream infectionscatheter-related bloodstream infections
spellingShingle Federico Turoldo
Antonella Longo
Mariavittoria Sala
Denis Valentini
Nicole De Vita
Sara Toniutti
Loredana Zuppel
Natalia Maximova
Nurse-Driven Interventions Reduce Central Line-Associated Bloodstream Infection Close to Zero in One Pediatric Oncologic Facility: A Single-Center Retrospective Observational Study
Nursing Reports
central venous catheter
pediatric
oncological
central line-associated bloodstream infections
catheter-related bloodstream infections
title Nurse-Driven Interventions Reduce Central Line-Associated Bloodstream Infection Close to Zero in One Pediatric Oncologic Facility: A Single-Center Retrospective Observational Study
title_full Nurse-Driven Interventions Reduce Central Line-Associated Bloodstream Infection Close to Zero in One Pediatric Oncologic Facility: A Single-Center Retrospective Observational Study
title_fullStr Nurse-Driven Interventions Reduce Central Line-Associated Bloodstream Infection Close to Zero in One Pediatric Oncologic Facility: A Single-Center Retrospective Observational Study
title_full_unstemmed Nurse-Driven Interventions Reduce Central Line-Associated Bloodstream Infection Close to Zero in One Pediatric Oncologic Facility: A Single-Center Retrospective Observational Study
title_short Nurse-Driven Interventions Reduce Central Line-Associated Bloodstream Infection Close to Zero in One Pediatric Oncologic Facility: A Single-Center Retrospective Observational Study
title_sort nurse driven interventions reduce central line associated bloodstream infection close to zero in one pediatric oncologic facility a single center retrospective observational study
topic central venous catheter
pediatric
oncological
central line-associated bloodstream infections
catheter-related bloodstream infections
url https://www.mdpi.com/2039-4403/14/4/197
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