Reduction of Bacteremia and Central Line Associated Complication Rate at the Pediatric Hemato-Oncology and Bone Marrow Transplant Department (PHOBMTD) of Sheba Medical Center

Background: Patients hospitalized at the Pediatric Hemato-Oncology and Bone Marrow Transplant Department of Sheba Medical Center are immunocompromised due to an extensive exposure to chemotherapy treatments and broad-spectrum antibiotics. Of the 805 patients who were admitted to the department during the year of 2017, 22% developed bacteremia, which led to central line associated bloodstream infection. The aim of this study was to reduce hospitalization days due to central line associated bloodstream infections and other complications by implementing a preventative measure and early intervention in the immunocompromised patients admitted to the department.

Methods: Information regarding catheter presence and catheter days was retrieved from computerized data and nurses` documentation. Data collection of pre intervention was from 01.07.2018 - 30.09.2018. Data collection of post intervention was from 01.07.2019- 30.09.2019. The interventions included staff simulation for of proper central line care including aseptic blood draws and blood cultures. The primary intervention was the implementation of 3M Curos Caps on all needless connectors replacing the "scrub the hub" practice.

Results: 98% compliance rate was achieved within three weeks of implementing the use of the 3M CurosTM caps. Bacteremia decreased by 40% compared with the previous year (2018). Culture contaminations decreased by 17%, and present on admission (POA) bacteremia decreased by 35%.

Conclusion: The positive clinical results, team satisfaction, and high compliance rate (over 98%), influenced the decision to implement the same standard of central line care in the outpatient hemato-oncology clinic and hospice unit of the department. The results reported are preliminary results and further research is required to establish the advantages ( reduce hospitalization days) of the intervention.