Most children receiving cancer treatment require a central venous catheter (CVC), putting them at risk for central line–associated bloodstream infections (CLABSI). As patients are discharged home with a CVC in place, caregivers are expected to maintain the CVC following an in-hospital education session before their first discharge home. Following a review of the literature, the education process was modified to improve the quality of education for caregivers. While the existing step-by-step handbook was reviewed and deemed aligned with best practices, other materials were added for this project: a caregiver skills competency checklist, a handout reviewing oral care and hygiene in the home, and a guide for nurses on what materials to provide families at the time of diagnosis. Additionally, caregivers were required to receive two additional CVC care reinforcement sessions during subsequent admissions to the inpatient units, which involved redemonstrations of skills using the competency checklist. Home-acquired CLABSI in pre- and postintervention groups were compared, and compliance of reinforcement education was measured. Though no statistical significance was found, the odds of experiencing a CLABSI were found to be higher in the preintervention group for mucosal-barrier injury (odds ratio = 2.23; 95% confidence interval [0.43, 22.10]) and laboratory-confirmed bloodstream infections (odds ratio = 4.53; 95% confidence interval [0.59, 203.71]). The clinical significance of reducing home-acquired CLABSI has a positive impact on patient outcomes by decreasing morbidity and mortality, inpatient lengths of stay, and overall health care costs.

中文翻译：

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减少小儿肿瘤患者在家中获得的中枢线相关血流感染

大多数接受癌症治疗的儿童需要使用中心静脉导管 (CVC)，这使他们面临中心静脉导管相关血流感染 (CLABSI) 的风险。由于患者出院回家时装有 CVC，因此在他们第一次出院回家之前，护理人员应在院内教育课程后维护 CVC。在查阅文献后，对教育过程进行了修改，以提高护理人员的教育质量。虽然对现有的分步手册进行了审查并认为与最佳实践保持一致，但为该项目添加了其他材料：护理人员技能能力清单、家庭口腔护理和卫生审查讲义以及护士指南确诊时提供给家属的材料。此外，护理人员在随后进入住院病房期间需要接受两次额外的 CVC 护理强化课程，其中包括使用能力清单重新展示技能。比较干预前和干预后组的家庭获得性 CLABSI，并测量强化教育的依从性。虽然没有发现统计学显着性，但发现预干预组因粘膜屏障损伤（比值比 = 2.23；95% 置信区间 [0.43, 22.10]）和实验室确诊的血流感染发生 CLABSI 的几率更高（优势比 = 4.53；95% 置信区间 [0.59, 203.71])。减少家庭获得性 CLABSI 的临床意义通过降低发病率和死亡率、住院时间、