According to a study conducted by Johns Hopkins researchers and published in Pediatrics, experts have developed a ‘triple-threat’ method for reducing risky infections in the central line in pediatric cancer patients. The approach, which has for the past two years stopped 1 in every 5 infections, includes living by a basic set of precautions, being honest about how the infection may have developed, and reporting if the family sees any noncompliance of protocol.

Reports from Johns Hopkins and other schools have shown that taking care of the central line severely reduces the risk of infection in very sick patients, however, this is the first study of its kind to look into the most susceptible pediatric patients, which are those going through various cancer treatment options and transplants of bone marrow.

To do this procedure, a central venous catheter, or central line is place inside important blood vessels in the groin, chest, neck in order to transport fluids, medicine, or blood.

The line may end up becoming a transport for bacteria and germs if it is not inserted the right way or if it is not properly handled after it is inserted. This may cause damage to organs and diseases.

Michael Rinke, M.D, a pediatrician and expert on patient safety at Johns Hopkins says:

“Children receiving cancer treatment are uniquely prone to invasive bloodstream infections because of their weakened immunity and because their central lines are accessed multiple times a day, with each entry posing a risk for infection.”

This new research was done by safety experts, physicians, and nurses of pediatric oncology from the Johns Hopkins pediatric inpatient cancer unit.

In order to avoid bacteria and other germs, the nurses came up with protocol of how to handle devices. Their method included:

  • Making sure the dressing over the central line was changed regularly
  • Cleaning the line every time before and after using it
  • Always using gloves and masks when touching the central line
  • Frequent washing of the hands before and after touching the line

In addition to these precautions, parents of the pediatric cancer patients were asked to use “do’s and don’ts” flashcards in order to help them learn the ways to for properly care for their child’s central line.

Kim Drucis, M.S.N., R.N., a pediatric oncology nurse commented:

“Parents can act as an invaluable second set of eyes, and we urged them to be vigilant about the way their child’s central line was handled. We also encouraged them to ask questions and to speak up every time they noticed something different.”

The nurses of the kids also held meetings each month to inform parents and others about what went on during the trial. This shows what worked and didn’t work during the study, therefore lowering the chance of making the same mistakes, and heightening the likelihood for success.

Co-author Stephanie Panton, M.S.N., R.N., C.P.O.N., said:”Honest dissection of one’s practice is neither easy nor pleasant but is absolutely critical to illuminate areas for improvement .” Rinke concluded:

“Real chance rarely occurs overnight. It requires sustained effort and unwavering focus, day after day, month after month, yeah after year. It’s a slow, arduous process, but the payoff can be dramatic.”

According to the Centers for Disease Control and Prevention, every year, 250,000 central line infections affect individuals in the U.S. The treatment of these infections cost about 25,000 each. Even more disturbing, 1 in 4 affected by these infections will die. Hopefully, new approaches, such as the ones that the Johns Hopkins team has created, will improve the care of central lines and avoid deaths among pediatric cancer patients.

Written by Christine Kearney