New PICU Protocol Reduces Central Line-Associated Bloodstream Infections

American Family Children’s Hospital’s pediatric intensive care unit (PICU) has instituted a protocol that has reduced central line associated blood stream infections (CLA-BSIs) — and likely decreased the time very sick patients spend in the hospital. National statistics also suggest the initiative may have saved lives.

The new protocol, developed by the National Association of Children’s Hospitals and Related Institutions, identified standard interventions that decrease infections. The protocol’s maintenance bundle includes instruction on when to change dressings surrounding central lines, having nurses wear masks when changing dressings, and creating central line kits that have all of the equipment needed for dressing changes.

Since the protocol’s implementation, the improvement in the PICU has been quantifiable. The PICU staff followed an insertion bundle when placing a central line and the maintenance bundle when accessing the line since November 2013 and went 354 days without a CLA-BSI.

Since that October 2014 infection, the PICU has been CLA-BSI-free, a string of more than 200 days.

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