Yearlong research led by Marlene Miller, M.D. Ms.C., of the Johns Hopkins Children’s Center with colleagues from other hospitals saw a 43 percent drop in the rate of bloodstream infections from catheters in 29 pediatric intensive care units (PICUs) that focused on careful placement and basic daily cleaning of the devices.
Results are to be published in the February issue of the journal Pediatrics.
Each year, 250,000 central line infections occur in the United States, researchers estimate, and up to one-fourth of patients die from them. Between 10 and 20 percent of children who get such infections die from them, researchers believe, and each infection carries a cost of $50, 000.
“If every single pediatric intensive care unit applies this approach rigorously and systematically, I’d be surprised if it didn’t translate into hundreds of lives and millions of dollars saved,” says Miller. Miller serves as vice president for quality transformation at the National Association of Children’s Hospitals and Related Institutions (NACHRI), which spearheaded the initiative.
A central venous catheter, or central line, is a tube inserted into a major blood vessel in the neck, chest or groin to serve as a temporary portal for injected medications and fluids, or blood sampling in patients who need them frequently. Because central lines also provide quick access in emergencies, children in the PICU often have them for weeks or longer. But if inserted incorrectly and, more importantly, mishandled after that, the central line can become a contaminated gateway for bacteria to enter directly into the patient’s bloodstream.
Therefore, investigators say, simple precautions like regularly changing the dressing covering the central line, changing the tubes and caps attached to it, cleaning the line before and after use, and rigorous hand washing before handling the line are essential to keeping bacteria away.
The new research also showed that while proper placement and daily care were both important in reducing catheter-related bloodstream infections, proper daily maintenance played the greatest role in preventing infections in children.
“Children, for example, may require more frequent blood draws through their catheter than adult patients so their central lines are handled more frequently on a day-to-day basis, which makes routine care for the device that much more critical in children than in adults,” Miller says.
The research further showed that medical staff compliance with day-to-day handling of central lines increased from 65 percent to 82 percent during the study period, suggesting that continuing education of medical staff and reminders to follow catheter protocol should be a mainstay in every PICU.
The research, launched as part of a nationwide effort to minimize preventable complications and deaths from this commonly used intravenous device, continues with more than 40 PICUs joining the initiative over the last two years. The effort continues today with more than 60 PICUs and is focused on further improving daily practices for central line handling.
Co-investigators include Michael Griswold, Ph.D., and Gayane Yenokyan, M.D. M.P.H. , of the Johns Hopkins Bloomberg School of Public Health; Mitchell Harris II, Ph.D., NACHRI; Charles Huskins, M.D., Mayo Clinic; Michele Moss, M.D., Arkansas Children’s Hospital; Tom Rice, M.D., Children’s Hospital of Wisconsin; Debra Ridling, R.N. , M.S., C.C.R.N., Children’s Hospital and Regional Medical Center, Seattle; Deborah Campbell, R.N., C. C.C.R.N., Kasair Children’s Hospital; Peter Margolis, M.D. Ph.D., Center for Child Health Quality; Richard Brilli, M.D., Nationwide Children’s Hospital.
Founded in 1912 as the children's hospital of the Johns Hopkins Medical Institutions, the Johns Hopkins Children's Center offers one of the most comprehensive pediatric medical programs in the country, treating more than 90,000 children each year. Hopkins Children’s is consistently ranked among the top children's hospitals in the nation. Hopkins Children’s is Maryland's largest children’s hospital and the only state-designated Trauma Service and Burn Unit for pediatric patients. It has recognized Centers of Excellence in dozens of pediatric subspecialties, including allergy, cardiology, cystic fibrosis, gastroenterology, nephrology, neurology, neurosurgery, oncology, pulmonary, and transplant. For more information, please visit www.hopkinschildrens.org
Colorectal cancer risk factors decrypted
13.07.2018 | Max-Planck-Institut für Stoffwechselforschung
Algae Have Land Genes
13.07.2018 | Julius-Maximilians-Universität Würzburg
For the first time ever, scientists have determined the cosmic origin of highest-energy neutrinos. A research group led by IceCube scientist Elisa Resconi, spokesperson of the Collaborative Research Center SFB1258 at the Technical University of Munich (TUM), provides an important piece of evidence that the particles detected by the IceCube neutrino telescope at the South Pole originate from a galaxy four billion light-years away from Earth.
To rule out other origins with certainty, the team led by neutrino physicist Elisa Resconi from the Technical University of Munich and multi-wavelength...
For the first time a team of researchers have discovered two different phases of magnetic skyrmions in a single material. Physicists of the Technical Universities of Munich and Dresden and the University of Cologne can now better study and understand the properties of these magnetic structures, which are important for both basic research and applications.
Whirlpools are an everyday experience in a bath tub: When the water is drained a circular vortex is formed. Typically, such whirls are rather stable. Similar...
Physicists working with Roland Wester at the University of Innsbruck have investigated if and how chemical reactions can be influenced by targeted vibrational excitation of the reactants. They were able to demonstrate that excitation with a laser beam does not affect the efficiency of a chemical exchange reaction and that the excited molecular group acts only as a spectator in the reaction.
A frequently used reaction in organic chemistry is nucleophilic substitution. It plays, for example, an important role in in the synthesis of new chemical...
Optical spectroscopy allows investigating the energy structure and dynamic properties of complex quantum systems. Researchers from the University of Würzburg present two new approaches of coherent two-dimensional spectroscopy.
"Put an excitation into the system and observe how it evolves." According to physicist Professor Tobias Brixner, this is the credo of optical spectroscopy....
Ultra-short, high-intensity X-ray flashes open the door to the foundations of chemical reactions. Free-electron lasers generate these kinds of pulses, but there is a catch: the pulses vary in duration and energy. An international research team has now presented a solution: Using a ring of 16 detectors and a circularly polarized laser beam, they can determine both factors with attosecond accuracy.
Free-electron lasers (FELs) generate extremely short and intense X-ray flashes. Researchers can use these flashes to resolve structures with diameters on the...
13.07.2018 | Event News
12.07.2018 | Event News
03.07.2018 | Event News
13.07.2018 | Event News
13.07.2018 | Materials Sciences
13.07.2018 | Life Sciences