Reducing catheter-associated bloodstream infections in the pediatric intensive care unit: Business case for quality improvement

Jeffrey E. Nowak, Richard J. Brilli, Michael R. Lake, Karen W. Sparling, John Butcher, Marion Schulte, Derek S. Wheeler

Research output: Contribution to journalArticlepeer-review

54 Scopus citations

Abstract

Objective: To determine whether catheter-associated bloodstream infections were associated with increased lengths of stay in pediatric intensive care units and hospitals and increased healthcare costs in critically ill children. Previous studies have shown that hospital-acquired bloodstream infections are associated with longer stays in pediatric intensive care units, increased hospital costs, and increased hospital mortality. Catheter-associated bloodstream infections comprise the vast majority of hospital-acquired bloodstream infections. Design: Retrospective, case-matched, cohort study and financial analysis. Setting: University-affiliated children's medical center. Patients Twenty-two critically ill children with catheter-associated bloodstream infections and their matched controls. INTERVENTIONS: None. MEASUREMENTS AND MAIN Results: We compared the ength of stay, mortality, and hospital costs in critically ill children with catheter-associated bloodstream infections and matched controls. The presence of catheter-associated bloodstream infections extended the entire hospital length of stay by 9 days (6.5 days while in the pediatric intensive care unit) and increased hospital costs by $33,039, primarily driven by the increase in length of stay days. Quality improvement efforts directed at reducing the prevalence of catheter-associated bloodstream infections during the period of study decreased total hospital days by 354, reduced total hospital costs by $1,298,271, and reduced total costs to payers by $1,415,676. Conclusion: The potential cost savings from reducing or eliminating catheter-associated bloodstream infections in the pediatric intensive care unit are significant. Elimination of catheter-associated bloodstream infections will directly reduce hospital costs, improve asset utilization, and most importantly, improve clinical care.

Original languageEnglish (US)
Pages (from-to)579-587
Number of pages9
JournalPediatric Critical Care Medicine
Volume11
Issue number5
DOIs
StatePublished - Sep 2010

Keywords

  • business case for quality
  • catheter-associated bloodstream infections
  • hospital revenue
  • increased healthcare costs
  • nosocomial infection
  • patient safety

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Critical Care and Intensive Care Medicine

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