Stories about: CICU

Scrubbing out central line infections

catheter hub cleaning
Sarah Goldberg and Ali Ataollahi pitching their device, which cleans central-line hubs with the push of a button, at Boston Children’s Hospital’s Innovation Tank.

Thousands of hospital patients die every year from infections that start in a central line, a catheter used to inject life-saving medications directly into the bloodstream. One infection can add two to three weeks and a whopping $55,000 to a patient’s hospital stay. Even worse, up to 25 percent of patients who come down with a central line infection die from it—a staggering number considering that 41,000 such infections are recorded in the U.S. each year.

“Central line infections are life-threatening, costly and completely preventable,” says Sarah Goldberg, MD, a fellow in Boston Children’s Hospital’s Cardiac Intensive Care Unit (CICU).

The problem is that the catheter’s hub—the port where it enters the body—is exposed to bacteria in the world around it. If clinicians don’t thoroughly clean the hub before each use, they risk pushing bacteria straight into a patient’s blood. But that brings up a second problem.

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In the ICU, nurse experience and education can mean life or death

Morning rounds on the pediatric cardiac ICU.
Morning rounds on the pediatric cardiac intensive care unit.

Registered nurses (RNs) remain the largest group of health care providers and typically account for the greatest share of most U.S. hospitals’ operating budgets, about 60 percent. In adult hospitals, research has shown a consistently positive effect of increasing percentages of nurses with baccalaureate educations, and linked increased RN staffing and healthy work environments with improved patient outcomes.

However, this assessment has not been conducted in children’s hospitals—until now.

In a study in the Journal of Nursing Administration, nursing leaders from 38 free-standing children’s hospitals explored which nursing and organizational characteristics influence mortality for children undergoing congenital heart surgery.

The study, involving 20,407 pediatric patients and 3,413 pediatric critical care nurses, was led by Patricia Hickey, PhD, MBA, RN, from the Heart Center at Boston Children’s Hospital.

In pediatrics, congenital heart disease is the most common birth defect requiring surgical intervention for survival. Due to their critical care needs, these patients consume a disproportionate share of U.S. hospital resources.

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