Document Type
Article
Publication Date
2026
DOI
10.1097/pq9.0000000000000885
Publication Title
Pediatric Quality & Safety
Volume
11
Issue
4
Pages
e885
Abstract
Introduction: Preventing ambulatory central line-associated bloodstream infections (A-CLABSIs) is challenging due to inconsistent education, follow-up, and home care practices. Pediatric intestinal failure (IF) patients are particularly vulnerable. This institution aimed to decrease its IF A-CLABSI rate by 25% within 2 years through a standardized, step-by-step central line care education program.
Methods: Using the Toyota problem-solving method, the team reviewed data and performed a root cause analysis of the prioritized problem, implementing a 2-phase education program. Phase 1 delivered in-hospital education using videos, handouts, and hands-on teaching with skill demonstration. The existing pediatric central line skills class was expanded and offered to partnering home health agencies. Phase 2 included postdischarge follow-up via phone calls or clinic visits to address questions and identify needs. Family feedback was collected through surveys.
Results: The average IF A-CLABSI rate decreased from 3.66 per 1,000 ambulatory line days to 1.85, representing a 49.5% reduction (P = 0.1479). One hundred percent of families surveyed at 7 days postdischarge reported confidence in providing central line care at home and found follow-up phone calls very helpful. Among 44 home health staff trained, the mean percent improvement in pre- to posttest scores was 47%. Families and home health personnel especially valued the hands-on learning component.
Conclusions: The standardized education program substantially reduced the rate of IF A-CLABSIs and improved confidence and satisfaction among families and home health nurses. It also enhanced collaboration among families, home health agencies, and the health system, fostering trust and continuity of care.
Rights
© 2026 the Authors
This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives International 4.0 License (CC BY-NC-ND 4.0), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
Original Publication Citation
Martinez, E., Bordeaux, B., Langevin, S., Herrera, C., Smith, M., Doyle, M., Stein, B., Poshar, K., Dunlap, M., Silva, A., & Werner, E. (2026). Empowering caregivers, protecting patients: An ambulatory central line quality improvement initiative for education and follow-up. Pediatric Quality & Safety, 11(4), Article e885. https://doi.org/10.1097/pq9.0000000000000885
Repository Citation
Martinez, E., Bordeaux, B., Langevin, S., Herrera, C., Smith, M., Doyle, M., Stein, B., Poshar, K., Dunlap, M., Silva, A., & Werner, E. (2026). Empowering caregivers, protecting patients: An ambulatory central line quality improvement initiative for education and follow-up. Pediatric Quality & Safety, 11(4), Article e885. https://doi.org/10.1097/pq9.0000000000000885
Help Prevent Central Line Infections
pq9_1_1_2026_05_12_martinez_pqs-d-25-00131_sdc2.pdf (137 kB)
SDC2, Bundle Letter
pq9_1_1_2026_05_12_martinez_pqs-d-25-00131_sdc3.pdf (292 kB)
SDC3, Paper Ambulatory CLABSI Huddle Form
pq9_1_1_2026_05_12_martinez_pqs-d-25-00131_sdc4.pdf (295 kB)
SDC4, Table
pq9_1_1_2026_05_12_martinez_pqs-d-25-00131_sdc5.pdf (142 kB)
SDC5, Home Health Scoring Histogram