"The goal of any pediatric oncologist is not to admit their patients," Rinke says. "These kids go through so much already and to have them in the hospital for an infection they didn't need to get is heartbreaking for everyone involved. Any time we can keep them out of the hospital that is a huge win. And it also a huge win for the medical system in terms of dollar because each of those hospitalizations cost real money for insurance companies and hospitals that don't get reimbursed for these infections all the time any more. It a real quality of life issue for the kids to say nothing of the risk for mortality and lasting morbidity."
Clinicians leading the study saw that homecare nurses and families received additional training in hand hygiene, tube changing and the use of needles, gloves, masks and dressings. Teams held regular meetings, webinars, and learning sessions to discuss quality improvement practices and to identify lessons learned from every infection.
Families also received education on central line safety, were asked to monitor provider compliance and regularly were asked to demonstrate their own abilities to care for their child's central line.
Rinke says the common-sense protocols are easy to implement, but can prove challenging to maintain. "It's the same thing when people floss when they're about to go to the dentist," he says. "We need to be reminded, but more importantly we need to have systems in place to make sure everybody does the right thing every time."