title: A crossover randomized prospective pilot study evaluating a central venous catheter team in reducing catheter-related bloodstream infections in pediatric oncology patients.
abstract: BACKGROUND
  Treatment for most children with cancer includes the use of a central venous catheter (CVC). CVCs provide reliable venous access for delivery of chemotherapy and supportive care. This advantage is mitigated by an increased risk of bloodstream infections (BSIs). Despite the ubiquitous use of CVCs, few prospective studies have been conducted to address infection prevention strategies in pediatric oncology patients.
  
  
  METHODS
  Prospective, crossover pilot study of a CVC team intervention versus standard care.
  
  
  METHODS
  Two inpatient oncology units in a metropolitan children's hospital.
  
  
  METHODS
  A total of 41 patients/135 admissions for the experimental unit (EU) and 41/129 admissions for the control unit (CU).
  
  
  METHODS
  Patients received a CVC blood draw bundle procedure by a CVC registered nurse (RN) team member (experimental intervention: EU) for 6 months and by the assigned bedside RN (standard care: CU) for 6 months. Feasibility of implementing a CVC RN team; a significant difference in CVC-related BSIs between the team intervention versus standard care and risk factors associated in the development of CVC-related BSIs were determined.
  
  
  RESULTS
  There were 7 CVC-related BSIs/1238 catheter days in the EU group (5.7/1000 catheter days) versus 3 CVC-related BSIs/1419 catheter days in the CU group (2.1/1000 catheter days; P = .97). Selected risk factors were not significantly associated with the development of a CVC-related BSI.
  
  
  CONCLUSIONS
  A CVC team in the care of pediatric oncology patients is feasible; however, a larger cohort will be required to adequately determine the effectiveness of the team reducing CVC-related BSIs.
authors.affiliation: Children's Hospital Los Angeles, Los Angeles, CA 90027, USA. rsecola@chla.usc.edu
authors.forename: Rita
authors.initials: R
authors.lastname: Secola
authors.forename: Colleen
authors.initials: C
authors.lastname: Azen
authors.forename: Mary Ann
authors.initials: MA
authors.lastname: Lewis
authors.forename: Nancy
authors.initials: N
authors.lastname: Pike
authors.forename: Jack
authors.initials: J
authors.lastname: Needleman
authors.forename: Richard
authors.initials: R
authors.lastname: Sposto
authors.forename: Lynn
authors.initials: L
authors.lastname: Doering
mesh_terms: D002405:Catheterization, Central Venous / Q000009:adverse effects*; D002648:Child; D018592:Cross-Over Studies; D005260:Female; D006776:Hospitals, Pediatric; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000150:complications / Q000628:therapy*; D010865:Pilot Projects; D011446:Prospective Studies; D018805:Sepsis / Q000150:complications / Q000517:prevention & control*