Saving Money and Kids' Lives

Wilmington, DE –Through its participation in a nationwide network of children’s hospitals dedicated to eradicating central line-associated blood stream infections (CLABSIs) in hospitalized children, Nemours/Alfred I. duPont Hospital for Children has prevented 68 of these infections and saved $2,377,229 in health care spending.

In collaboration with more than 80 other children’s hospitals nationwide, duPont Hospital for Children’s participation in the National Association of Children’s Hospitals and Related Institutions (NACHRI) Quality Transformation Network (QTN) has helped save 355 children’s lives, prevented 2,964 central line infections, and passed the $100 million mark for total cost savings.

“Reaching this milestone proves how vital the NACHRI QTN has been and will continue to be,” explains Barbara A. Jackson, RN, BSN; VPS/NACHRI Coordinator PICU, duPont Hospital for Children. “The steps taken in this collaborative have been incorporated into our current practices hospital-wide. More important than the money we’ve saved are the lives of children saved thanks to this collaboration.”

“NACHRI congratulates Alfred I. duPont Hospital for Children on this well-timed milestone,” said Lawrence McAndrews, president and CEO of NACHRI. “Together, children’s hospitals have successfully eliminated $100 million in preventable hospital costs at a time when legislators are making decisions about critical health care funding. Children’s hospitals are demonstrating that they are leaders in pioneering quality improvement solutions that not only save money but, most importantly, save lives.”

What is a Central Line Infection or CLABSI?

CLABSIs are infections that occur in patients’ central venous catheters (a central line is flexible medical tubing inserted into the body). They are also a preventable harm that carries a price tag of at least $25,000-$45,000 per event and a 10 to 20 percent mortality risk for children.

“As the NACHRI QTN enters its sixth year, our faculty and clinical teams in children’s hospitals are continually pushing to improve care for our patients,” said NACHRI Quality Transformation Vice President Marlene Miller, MD, MSC. “Because the pediatric community is small and nimble, we can spread proven practice opportunities more rapidly, providing better quality care for children at lower overall costs.” With 162 units from 88 hospitals, 40 percent of NACHRI’s 220-member hospitals have participated to date in this national effort to eradicate pediatric CLABSIs, as well as other health care associated infections.

In adult intensive care, CLABSIs have been significantly decreased through a multi-faceted intervention. Until the NACHRI QTN, the efficacy of the adult intervention in pediatric patients was unknown.

Using a model distinguished by collaboration combined with rigorous methodologies, tightly coordinated implementation and rich large data sets, NACHRI QTN hospitals have learned that reducing CLABSI events requires an approach combining evidence-based guidelines for catheter insertion with daily maintenance care for central lines. In fact the main driver in reducing CLABSI infections is the reliable use of the recommended daily maintenance care for central lines.

A January 2010 Pediatrics journal article published the first set of findings of the NACHRI QTN that clearly differentiate the effect of insertion-related practices, well documented in adult-patient academic literature as driving the reduction of CLABSIs in intensive care, from maintenance-related practices that are predictive of being able to reduce children’s CLABSI rates. It will publish updated findings from the NACHRI QTN in an upcoming issue.