Best Practices for Central Line Use

The Problem

According to the CDC, 248,000 bloodstream infections occur in U.S. hospitals each year, a large proportion of which are believed to be central line-associated bloodstream infections. In 2007, the national incidence rate for CLABSI for pediatric ICUs was 3.7 per 1,000 central line days, down from 7.8 per 1,000 days in 1997 but still an area of concern. For the often critically ill patients at Children's Hospital, many of whom have multiple complications,any infection can pose life-threatening risks, according to Derrick McQueen, MD, acting director of pediatric critical care medicine at Children's Hospital.

The Solution

In 2006, the hospital began participating in a pilot initiative of the National Association of Children's Hospitals and related institutions to reduce CLABSI rates among its members. The pediatric intensive care unit at Children's Hospital subsequently adopted a comprehensive central line bundle designed to ensure central line sterilization, organize and monitor central line supplies, incorporate evolving practices for central line safety and standardize guidelines for the maintenance of patients' central line dressings.

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