O2166: Empowering Caregivers, Protecting Patients: An Ambulatory Central Line Education Program

Purpose/Objectives: Preventing ambulatory central line-associated blood stream infections (A-CLABSIs) is a challenging endeavor, often due to lack of standardized education and follow-up as well as variations in home care practices. More often, families are managing central line care from home and a lack of preparedness in central line care can increase stress and risk of infection.

It was hypothesized that by standardizing education and follow-up, family satisfaction and comfort level of at-home central line care would improve and the number of unique intestinal failure (IF) A-CLABSIs, the population with the most infections at our institution, would decrease.

Design/Methods: The Toyota Problem Solving method was used to collect/analyze data and perform root cause analysis on the prioritized problem. A two-phase education program was tested. Phase 1 included in-hospital education through videos, handouts and hands-on teaching with skill demonstration and teach-back.

Phase 2 included post-discharge follow-up at frequencies of 24/48 hours, 7, 14, 30/45 and 90 days, where questions were answered, and patient and family needs were identified. An existing central line skills class was revised and offered to partnering home health agencies to ensure education consistency in the home. Infection rates were monitored, family feedback was obtained through surveys, while home health staff attendees provided feedback through evaluations. Pre- and post-scores were collected during each central line skills class.

Results: The average number of unique IF A-CLABSIs decreased from 3.13 to 1.35 per month, a 56.9% decrease (Figure 1).

100% of families surveyed stated that receiving post-discharge follow-up phone calls was helpful and ‘nice to know someone cared and thought to check on them’. All families agreed that in-hospital education helped prepare them to care for their child’s central line at home.

The 27 home health staff trained in pediatric central line care skills across five agencies showed an average pre- to post-score improvement of 37.7% (Figure 2). Both families and home health personnel especially appreciated the hands-on learning component.

Conclusion/Discussion: Implementation of a standardized central line education program improved both home health nurse and family satisfaction and confidence in performing central line care, while the average number of unique IF A-CLABSIs decreased by more than half. Additional benefits included improved collaboration between home health, families and the health system, fostering trust.