Critical Care

Zero Central Line Infections in Our Pediatric and Neonatal Intensive Care Units in 2009

For children with illnesses that require longer hospital stays or long-term treatments it’s common to get a central line (a long, thin, flexible tube that’s surgically placed into the larger veins of the neck or groin and travels to a large blood vessel near the heart). Having a central line enables doctors and nurses to draw blood and provide medications to kids for as long as medically necessary—sparing them the fear and stress of repeated needle sticks.

Unfortunately, central line infections can happen if bacteria enter the catheter and get into the child’s bloodstream. Every year catheter-associated bloodstream infections cause added medical costs, illness, and (on rare occasions) death in hospitalized adults and children worldwide.

However, if your child needs a central line the last thing you’re probably thinking about is an infection. At Nemours, we make sure that’s one less worry on your mind. We take every precaution to ensure that our patients don’t get a central line infection. And our efforts are making a real difference in the health and safety of the newborns and children we treat.

We’re One of the Best

When it comes to preventing central line infections in our intensive care units (where children come when they need critical care), at Nemours we’re incredibly proud to say that we’re doing far better than many hospitals nationwide. Here’s a quick look at our incredible achievements in avoiding central line infections:

• The March 2010 Consumer Reports magazine recognized our pediatric intensive care unit (PICU) at the Nemours/Alfred I. duPont Hospital for Children for having 65% fewer infections than the national average. (Consumer Reports based their information on hospitals’ most recent data, primarily from 2008.)
• Our rate for 2009 was the best in the Philadelphia region and the entire state of Delaware for pediatrics. (Find out more about other hospitals’ rates in Delaware.)
  
• Both our PICU and neonatal intensive care unit (NICU) had no central line infections in all of 2009. That impressive feat comes on the heels of two previous years with infection rates that fell well below the national average, based on data from the Centers for Disease Control and Prevention (CDC).

About This Graph:

The national average (shown in the dotted blue line) is the Centers for Disease Control’s (CDC's) rate of 2.94 central-line-related bloodstream infections for every 1,000 days that all patients in an intensive care unit had a central line. The solid orange line represents duPont Hospital for Children’s central line infection rate for the previous 4 years. And it shows how much we’ve improved over time. We learned what worked best, put it into daily practice, and now we can say that our central line infection rate is substantially better than the national average.

How We Do It

So how have we kept our central line infection rates so low—even non-existent? It all starts with our participation in a collaborative effort supported by the National Association of Children’s Hospitals and Related Institutions (NACHRI, for short), which focuses on implementing “best practices” used in the preparation, insertion, and ongoing care of central lines.

“Best practices” in medicine refers to the treatments and processes health care providers use that are proven to really work and to be the most successful for patients—based on evidence from research as well as patient care. In addition, best practices used by health care providers are reliable when used again and again.

When it comes to central lines, best practices dictate that every nurse, physician, and other caregiver who comes into contact with patients’ central lines gets continuing education, coaching, and intervention (as needed) on how to reduce and eliminate blood infections associated with the use of a central line.

We adhere to a detailed checklist that follows crucial steps—like keeping hands, instruments, and the skin around the line area sanitized, as well as removing any unnecessary catheters.

At Nemours, we were early adopters of the safe practices for central lines because we saw that it was best for our patients—from the children of all ages in our PICU to our tiniest and most vulnerable patients in our NICU.

Through teamwork and ongoing coordination of our efforts and standards, we do whatever it takes to ensure that kids who need central lines stay free of preventable infections. And that equates to healthier patients—and more satisfied parents. Our goal, in our intensive care units and everywhere else we see patients, is to always treat every child as if they were our own.