Lo Vecchio, A., Schaffzin, J.K., Ruberto, E., Caiazzo, M.A., Saggiomo, L., Mambretti, D., . . . Guarino, A. (2016). Reduced central line infection rates in children with leukemia following caregiver training: A quality improvement study. Medicine, 95, e3946.

DOI Link

Study Purpose

A quality improvement project to educate caregivers on CL management and CLABSI prevention among children

Intervention Characteristics/Basic Study Process

The intervention consisted of nine in-person classes for education and practice on children and mannequins.

Sample Characteristics

  • N: 120   
  • AGE: Not mentioned
  • MALES: Not diversified  
  • FEMALES: Not diversified
  • CURRENT TREATMENT: Other
  • KEY DISEASE CHARACTERISTICS: ALL, AML, CL, CLABSI, QI, Pediatric hemato-oncology
  • OTHER KEY SAMPLE CHARACTERISTICS: Leukemia, caregivers

Setting

  • SITE: Single site   
  • SETTING TYPE: Multiple settings    
  • LOCATION: Santobono-Pausilipon Children’s Hospital, Italy

Phase of Care and Clinical Applications

  • PHASE OF CARE: Multiple phases of care
  • APPLICATIONS: Pediatrics

Study Design

QI project for in-person caregiver training classes; no ICF needed.

Measurement Instruments/Methods

CLABSI rate per 1,000 CL days in children with acute leukemia. The baseline was calculated based on previous 12 months of the QI project between March 2012 and April 2013 and was compared with cumulative CLABSI rates computed with 95% confidence intervals (CI).

Results

A total of 118 children were diagnosed with acute leukemia and included in the study. 120 caregivers of 118 children agreed to participate. Baseline CLABSI rate was 6.86 per 1,000 CL days; within 8 months, 3.7 per 1,000 CL days; 46.1% reduction attributable to intervention alone.

Conclusions

Implementing an education intervention for the reduction of CLABSI occurrences using evidence-based practices resulted in dramatic improvement of CLABSI rates and, in turn, survival rates of leukemic children.

Limitations

Subject withdrawals 10% or greater

Nursing Implications

Nursing is synonymous for teaching and educating the patient population. Nurses would be at the forefront of this intervention creating a comprehensive explanation of the disease process in a palatable form for caregivers as well as reinforcement and encouragement.