The title of this project is Eliminating Catheter-Associated Blood Stream Infections (CA-BSIs) in Chronic Central Lines. The overall goal of the proposed research is to determine whether best practice care bundles for the management of acute central lines in pediatric intensive care units (PICU) can be tailored and disseminated to the pediatric hematology / oncology population to reduce catheter-associated bloodstream infections in this high-risk population with chronic central lines. The National Association of Children's Hospitals and Related Institutions has developed, sustained, and spread a quality improvement collaborative focused on the elimination of CA-BSI among patients with acute central lines in the PICU. After three years, the average CA-BSI rate across PICUs has dropped dramatically from 5.5 infections per 1,000 central line days to approximately 1 infection per 1,000 central line days. Despite this, it remains unknown what best practices should be with chronic central venous catheters outside the ICU setting. Our proposal will address this by working with 25 children's hospitals to reduce central line infections among children with oncologic and chronic hematologic conditions with chronic central venous catheters. Successful completion of this project will provide the Agency for Healthcare Research and Quality, providers, patients, payers, and policymakers with effective tools for spreading CA-BSI eradication efforts outside ICUs to the large population of patients with chronic central lines. This knowledge for best care of chronic central lines is the logical first step to eliminating central line infections in all chronic care settings including the home and ambulatory arenas.

Public Health Relevance

The overall goal of the proposed research is to determine whether best practice care bundles for the management of acute central lines in intensive care units can be tailored and disseminated to the general care pediatric hematology / oncology population and reduce catheter-associated bloodstream infections in this high- risk population with chronic central lines. Our proposal will accomplish this by partnering with 25 children's hospitals. Successful completion of this project will provide the Agency for Healthcare Research and Quality, providers, patients, payers, and policymakers with effective tools for spreading CA-BSI eradication efforts outside ICUs to the large population of patients with chronic central lines.

Agency
National Institute of Health (NIH)
Institute
Agency for Healthcare Research and Quality (AHRQ)
Type
Research Demonstration and Dissemination Projects (R18)
Project #
1R18HS019590-01
Application #
8016154
Study Section
Health Care Technology and Decision Science (HTDS)
Program Officer
Hogan, Eileen
Project Start
2010-09-30
Project End
2012-09-29
Budget Start
2010-09-30
Budget End
2011-09-29
Support Year
1
Fiscal Year
2010
Total Cost
Indirect Cost
Name
Johns Hopkins University
Department
Pediatrics
Type
Schools of Medicine
DUNS #
001910777
City
Baltimore
State
MD
Country
United States
Zip Code
21218
Bundy, David G; Gaur, Aditya H; Billett, Amy L et al. (2014) Preventing CLABSIs among pediatric hematology/oncology inpatients: national collaborative results. Pediatrics 134:e1678-85
Gaur, Aditya H; Bundy, David G; Gao, Cuilan et al. (2013) Surveillance of hospital-acquired central line-associated bloodstream infections in pediatric hematology-oncology patients: lessons learned, challenges ahead. Infect Control Hosp Epidemiol 34:316-20