Tunneled hemodialysis catheter care practices and blood stream infection rate in children: results from the SCOPE collaborative.

Tytuł:: Tunneled hemodialysis catheter care practices and blood stream infection rate in children: results from the SCOPE collaborative.
Autorzy:: Marsenic O; Pediatric Nephrology, Yale University School of Medicine, 333 Cedar Street, New Haven, CT, 06510, USA. .
Rodean J; The Children's Hospital Association, Lenexa, KS, USA.
Richardson T; The Children's Hospital Association, Lenexa, KS, USA.
Swartz S; Texas Children's Hospital, Houston, TX, USA.
Claes D; Cincinnati Children's Hospital, Cincinnati, OH, USA.
Day JC; Children's Mercy Kansas City, Kansas City, MO, USA.
Warady B; Children's Mercy Kansas City, Kansas City, MO, USA.
Neu A; Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Corporate Authors:: Standardizing Care to Improve Outcomes in Pediatric End Stage Renal Disease (SCOPE) Investigators
Źródło:: Pediatric nephrology (Berlin, Germany) [Pediatr Nephrol] 2020 Jan; Vol. 35 (1), pp. 135-143. Date of Electronic Publication: 2019 Oct 25.
Typ publikacji:: Journal Article
Język:: English
Imprint Name(s):: Publication: Berlin : Springer International
Original Publication: Berlin : Springer International, c1987-
MeSH Terms:: Catheter-Related Infections/*epidemiology
Catheterization, Central Venous/*adverse effects
Kidney Failure, Chronic/*therapy
Renal Dialysis/*adverse effects
Sepsis/*epidemiology
Adolescent ; Catheter-Related Infections/etiology ; Catheterization, Central Venous/instrumentation ; Catheterization, Central Venous/standards ; Catheterization, Central Venous/statistics & numerical data ; Central Venous Catheters/adverse effects ; Central Venous Catheters/standards ; Central Venous Catheters/statistics & numerical data ; Child ; Child, Preschool ; Female ; Guideline Adherence/statistics & numerical data ; Humans ; Infant ; Infant, Newborn ; Intersectoral Collaboration ; Male ; Practice Guidelines as Topic ; Practice Patterns, Physicians'/organization & administration ; Practice Patterns, Physicians'/standards ; Practice Patterns, Physicians'/statistics & numerical data ; Program Evaluation ; Prospective Studies ; Quality Improvement/organization & administration ; Renal Dialysis/instrumentation ; Renal Dialysis/standards ; Renal Dialysis/statistics & numerical data ; Sepsis/etiology ; Standard of Care/organization & administration ; Standard of Care/statistics & numerical data ; Young Adult
References:: Am J Kidney Dis. 2005 Apr;45(4):708-14. (PMID: 15806474)
J Am Soc Nephrol. 2018 Apr;29(4):1336-1343. (PMID: 29472415)
Infect Control Hosp Epidemiol. 2012 May;33(5):521-3. (PMID: 22476281)
Nephrol Dial Transplant. 2019 Oct 1;34(10):1746-1765. (PMID: 30859187)
Am J Kidney Dis. 2019 Aug;74(2):193-202. (PMID: 31010601)
Pediatr Nephrol. 1999 Apr;13(3):245-8. (PMID: 10353415)
Pediatr Nephrol. 2014 Oct;29(10):2013-20. (PMID: 24474576)
Pediatr Nephrol. 2006 Oct;21(10):1452-8. (PMID: 16897007)
Semin Dial. 2008 Nov-Dec;21(6):528-38. (PMID: 19000122)
N Engl J Med. 2011 Jan 27;364(4):303-12. (PMID: 21268722)
Clin J Am Soc Nephrol. 2016 Sep 7;11(9):1590-6. (PMID: 27340282)
Clin J Am Soc Nephrol. 2017 Oct 6;12(10):1601-1614. (PMID: 28877926)
Int J Clin Exp Med. 2015 Jun 15;8(6):9765-71. (PMID: 26309654)
Pediatr Nephrol. 2014 Sep;29(9):1477-84. (PMID: 25055994)
Am J Kidney Dis. 2013 Aug;62(2):322-30. (PMID: 23676763)
Kidney Int. 2016 Jun;89(6):1346-54. (PMID: 27165827)
Pediatr Nephrol. 2009 Nov;24(11):2087-95. (PMID: 19629533)
Pediatrics. 2015 Nov;136(5):e1331-44. (PMID: 26459655)
J Pediatric Infect Dis Soc. 2015 Dec;4(4):363-6. (PMID: 26582876)
Infect Control Hosp Epidemiol. 2016 Jul;37(7):863-6. (PMID: 26868605)
Hemodial Int. 2014 Oct;18 Suppl 1:S13-8. (PMID: 25330826)
Clin J Am Soc Nephrol. 2011 Apr;6(4):793-8. (PMID: 21127138)
Clin J Am Soc Nephrol. 2017 Jul 7;12(7):1139-1146. (PMID: 28663227)
Clin J Am Soc Nephrol. 2017 Aug 9;:. (PMID: 28794000)
Expert Rev Anti Infect Ther. 2010 Nov;8(11):1239-49. (PMID: 21073289)
Pediatr Nephrol. 2012 Jun;27(6):999-1004. (PMID: 22205507)
Contributed Indexing:: Keywords: Blood stream infection; Catheter infection; Hemodialysis; Infection prevention
Entry Date(s):: Date Created: 20191027 Date Completed: 20201221 Latest Revision: 20201221
Update Code:: 20240104
DOI:: 10.1007/s00467-019-04384-7
PMID:: 31654224
: Czasopismo naukowe

Pełny tekst

Objective: The Standardizing Care to Improve Outcomes in Pediatric End Stage Renal Disease (SCOPE) collaborative seeks to reduce hemodialysis (HD) catheter-associated blood stream infections (CA-BSI) by increasing implementation of standardized HD catheter care bundles. We report HD catheter care practices and HD CA-BSI rates from SCOPE.
Methods: Catheter care practices and infection events were collected prospectively during the study period, from collaborative implementation in June 2013 through May 2017. For comparative purposes, historical data, including patient demographics and HD CA-BSI events, were collected from the 12 months prior to implementation. Catheter care bundle compliance in 5 care bundle categories was monitored across the post-implementation reporting period at each center via monthly care observation forms. CA-BSI rates were calculated monthly, and reported as number of infections per 100 patient months. Changes in CA-BSI rates were assessed using generalized linear mixed model (GLMM) techniques.
Results: Three hundred twenty-five patients with tunneled HD catheters [median (IQR) age 12 years (6, 16), M 53%, F 47%] at 15 centers were included. A total of 3996 catheter care observations over 4170 patient months were submitted with a median (IQR) 5 (2, 14) observations per patient. Overall bundle compliance was high at 87.6%, with a significant and progressive increase (p < 0.001) in compliance for 4/5 bundle categories over the 48-month study period. The adjusted CA-BSI rate significantly decreased over time from 3.3/100 patient months prior to implementation of the care bundles to 0.8/100 patient months 48 months after care bundle implementation (p < 0.001).
Conclusions: Using quality improvement methodology, SCOPE has demonstrated a significant increase in compliance with a majority of HD catheter care practices and a significant reduction in the rate of CA-BSI among children maintained on HD.

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