A central venous catheter (CVC) is a hollow tube put into the vein used to give medications, intravenous fluids and nutritional supplements. It also can be used to obtain blood samples required to test progress of an ill child. Using the CVC for blood samples reduces the number of needle sticks a child has to have.
Why are catheters a concern?
While providing many advantages in treating our patients, central lines can also place patients at risk for a blood stream infection. The lines require special handling and the placement of sterile dressings over the insertion site so germs are less likely to enter the system. Every time a care provider has to expose or “open” the line, the risk of an infection increases.
What have we done to reduce the risk of infection?
In collaboration with 28 children’s hospitals, we developed the best pediatric practices for insertion and maintenance of central venous catheters. The effort focused on critically ill children in the Pediatric Intensive Care Unit. Dayton led the Race for Results among the hospitals that participated in this collaborative effort and received special recognition from the Child Health Corporation for excellent patient outcomes, having exceeded more than 18 months with no central line infections.
What are the best practices?
Daily the care team assesses the situation and sets goals for switching the child to oral medications and the introduction of formula of feed. In addition to this best practice,
Dayton Children’s follows the catheter insertion procedure that includes:
- Hand washing immediately before the procedure, using a large sterile drape to cover the patient
- Assuring care providers wear a cap and sterile gown and gloves during insertion
- Cleaning the insertion site with a special disinfectant
- Covering the site with a sterile dressing.
The site is maintained by following these steps:
- Hand washing immediately before removal of the previous dressing with providers wearing sterile gowns and gloves
- Cleaning the insertion site with disinfectant and maintaining a clean dressing at all times
- Replacing dressing that becomes damp, loosened or visibly soiled.
- Number of Patients Treated
- Reasons for Admissions
- Keeping My Child Safe
- Bloodstream Infections
- Asthma Relievers
- Patient Satisfaction
- Sickle Cell Pain and Fever
- Staff Flu Immunization Rate
- Readmissions and Transfers
- Emergency Codes Outside PICU
- PICU Survival Rates
- Pain Management
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