Critical Care Outcomes

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Why Choose Us: Critical Care

Our Outcomes: The Results of Our Care

Catheters are a common part of care in any pediatric intensive care unit (PICU). Children may have central venous catheters (or “central lines”) and/or urinary catheters. Unfortunately, infections can happen if bacteria enter the catheter and get into the child’s bloodstream. Central line-associated infections (CLABSI) and catheter-associated urinary tract infection (CAUTI) can impact children’s health, as well as increase medical costs and their length of stay.

If your child needs a central line or uninary catheter, the last thing you’re probably thinking about is an infection. That’s why our PICUs at Nemours/Alfred I. duPont Hospital for Children in Wilmington, Del., and Nemours Children’s Hospital in Orlando make sure that’s one less worry on your mind. We take every precaution to ensure that our patients — especially those who are critically ill and most vulnerable to other conditions — don’t get an infection. And our efforts are making a real difference in the health and safety of the children we treat. In fact, this extra care and attention has allowed us to achieve infection rates that are even better than national benchmarks (standards).

Why Measuring Results Matters

To provide pediatric care that's among the safest and most caring, we measure our results and compare them to national pediatric rates. Why? So we can:

  • help you make decisions about your child’s care
  • be clear about our results
  • improve and consistently deliver better, safer care

And we’re doing better than the national average in many specialties and processes.

Reducing Central Line Infections in Children

Reducing Central Line Infections in Children


Rate of Central Line-Associated Bloodstream Infections

For critically ill children, 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 allows 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.

We’re able to reduce central line-associated infections by:

  • following the routine use of insertion and maintenance bundles and checklists (that just means following crucial steps like keeping hands, instruments, and the skin around the line area sanitized, as well as removing the catheters if they’re no longer essential to your child’s care)
  • reviewing the continued need for central lines on daily rounds 
  • conducting detailed investigations if a central line-associated infection does happen. We want to figure out the cause and make any necessary changes.

 

Average Number of Central Line-Associated Bloodstream Infections (Nemours/Alfred I. duPont Hospital, Nemours Children’s Hospital PICUs)

4,806

Total number of patients who received central lines, 2016

3 infections

Average number of infections, 2016

2 infections

Average number of infections, 2015

1.30 infections

National average (benchmark)

 

Data source: The Nemours data was collected electronically with manual verification within the PICUs at both hospitals. The benchmark set by The Children’s Hospitals’ Solutions for Patient Safety Network (SPS) for 2016 for CLABSI is measured as 1.3 infections per 1,000 — or every 1,000 days that all patients in the intensive care unit had a central line.

Reducing Catheter-Associated Infections in Children

Reducing Catheter-Associated Infections in Children


Rate of Catheter-Associated Urinary Tract Infections

To drain urine, doctors and nurses may use a uninary catheter — a long, thin, flexible tube that’s inserted into the bladder via the urethra, which carries urine from the bladder out of the body. Having a urinary catheter allows children to pee without having to get up to go to the bathroom (and, for babies and toddlers, without having to use a diaper).

At Nemours, we strive to prevent catheter-associated urinary tract infection as much as possible. As a result, we’ve reduced our catheter-associated urinary tract infection rates to well below the national benchmark. We’re able to reduce catheter-associated UTIs by:

  • limiting the use of urinary catheters
  • monitoring twice daily during physician rounds whether catheters are still needed
  • reviewing a daily checklist to remove unnecessary lines or drains on physician rounds
  • using electronic monitoring tools for catheter alerts
  • limiting use to a maximum of five days for a majority of patients

 

Average Number of Catheter-Associated Urinary Tract Infections (Nemours/Alfred I. duPont Hospital, Nemours Children’s Hospital PICUs)

1,347

Total number of patients who received urinary catheters, 2016

0.5 infections

Average number of infections, 2016

2.5 infections

Average number of infections, 2015

1.20 infections

National average (benchmark)

 

Data source: The Nemours data was collected electronically with manual verification within the PICUs at both hospitals. The benchmark set by The Children’s Hospitals’ Solutions for Patient Safety Network (SPS) for 2016 for CAUTI is measured as 1.2 infections per 1,000 — or every 1,000 days that all patients in the intensive care unit had a uninary catheter.

Our Differentiators: What Sets Nemours Critical Care Apart

Our Differentiators: What Sets Nemours Critical Care Apart


Why Choose Us

  • The standard practices in our critical care units are built upon what’s called “evidence-based care.” This means the care we provide to your child (including any diagnostic testing, treatment and therapy) is based on what’s been proven to work best for children — what’s been proven over time in health care systems all across the country. Our methods and equipment are state-of-the-art, and delivered in a standardized fashion to reduce unnecessary variation.
  • We’re always actively and continuously improving our outcomes. Reducing our central line-associated infection and catheter-associated urinary tract infection rates are just two examples. You can see similar processes in many other areas, such as advanced airway management and physician-to-physician handoff (the passing on of all important medical and personal information from one doctor to another, such as change of shifts or from one medical specialty or department to another).
  • We take a collaborative, team approach. Our doctors and nurses work with other subspecialists and disciplines (from nursing, pharmacy and nutrition to physical therapy and Child Life) to give your child the most coordinated care. Care in our hospitals’ PICUs is intensive and integrated, which means clear communication between our doctors, nurses and technicians is crucial.
  • Our care is also family-centered, so your input is just as important. We value your participation in our daily rounds. Please ask questions and make sure you understand why your child may need a catheter and when it may no longer be necessary. Together, we can achieve true excellence in medical care — and help prevent unnecessary infections in our most vulnerable patients.

 

Learn More About Nemours Critical Care and Pediatric Intensive Care Units »