Children's Emergency Department is now located in Children's Tower: 1001 E. Marshall Street.

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Hematology and oncology

Quality and safety initiative

Hematology and oncology

Outpatient CLABSI

Central lines are small plastic tubes that go into blood vessels to safely give medications and take blood work from patients. These tubes can become infected called a CLABSI (central line-associated blood stream infection).  When they become infected at home, it is called an outpatient CLABSI.

How we are improving

We work with families and home health nurses to ensure that when children go home with a central line, that they will not have a CLABSI through education and training.

Why it matters to our patients

When a child has a CLABSI at home, they have to stay in the hospital for several days costing families time and money. Sometimes children have to have a procedure to change their central line.  Parents usually have to give their children antibiotics through their central line several times per day for a week or so after going home from the hospital.

How we measure

The chart below shows the rate of outpatient CLABSI (infections per 1000 catheter days). The green line shows our outpatient CLABSI rate compared to our goal rate in yellow (lower is better).

12 month rolling outpatient oncology CLABSI rate graph


Inpatient CLABSI

Central lines are small plastic tubes that go into blood vessels to safely give medications and take blood work from patients. These tubes can become infected called a CLABSI (central line-associated blood stream infection).  When they become infected in the hospital, it is called an inpatient CLABSI.

How we are improving

Our nurses are highly trained to safely use your child's central line. They will always use sterile gloves, special screw tops if your child's central line comes through the skin, and we will only take blood out of the central line or put medicines into the central line when necessary because we know that the less we use the line, the lower the risk of infection.

Why it matters to our patients

When a child has a CLABSI in the hospital, they can become very sick, they have to stay longer in the hospital, and the child's healthcare costs increase. Sometimes children have to have a procedure to change the central line. Parents usually have to give their children antibiotics through their central line several times per day for a week or so after going home from the hospital.

How we measure

The chart below shows the rate of inpatient CLABSI (infections per 1000 catheter days). The green line shows our CLABSI rate for hospitalized patients compared to our goal rate in yellow (lower is better). 

12 month rolling inpatient oncology CLABSI rate graph


Pain crisis in children with sickle cell disease

Pain is a common and debilitating symptoms of sickle cell disease (SCD). Children with SCD come to the emergency room when their home medicines do not control their pain.  Too often, they have to be admitted to the hospital for several days or a week to control their pain.

How we are improving

We have created clinical guidelines, as well as, individualized pain plans for many of our patients with sickle cell disease to ensure that they get fast and effective treatment of their pain whether they are home, in the emergency room, or in our clinic. We keep a close eye on which patients are admitted to the hospital for pain and work to improve their pain plan to keep them out of the hospital the next time.

Why it matters to our patients

Through our work, we have decreased the number of children with sickle cell who have to be hospitalized because of pain. We estimate that we prevent 45-60 admissions per year saving children and their families' pain, time, and money and getting them back to their lives faster.

How we measure

The chart below shows the percent of children seen in our ED for a pain crisis who are admitted to the hospital (lower is better).

4 month rolling admission rate for children with sickle cell disease in the ED with a pain crisis graph
 


We're here to help with any quality-related questions. Please contact:

Kara Heird, MPH, RNC-OB
Interim Quality Manager, Performance Improvement Coordinator
Kara.Heird@vcuhealth.org