The Effectiveness of Pediatric Central Venous Access Device Surveillance and Rounding Team: A Single-Center Study

Abstract

Introduction Central venous access devices (CVADs) are indispensable in the management of pediatric cancer patients, offering vital access to treatment. Yet, complications related to CVADs, such as infections, thrombosis, and dislocations, pose significant risks, potentially leading to prolonged hospitalization, intensive care unit admission, or even mortality. To address these challenges, our hospital established a pediatric CVAD surveillance and rounding team to improve the management and care of pediatric patients with CVADs. Materials and methods This single-center retrospective study evaluated the impact of the pediatric CVAD surveillance and rounding team on the management of pediatric oncology patients with CVADs at Kurashiki Central Hospital, Kurashiki, Japan. We included pediatric cancer patients under 18 years of age who underwent CVAD placement from January 2018 to December 2022. The team conducted weekly rounds focusing on a comprehensive checklist to ensure optimal CVAD care. We compared the incidence of catheter-related complications before and after the establishment of the rounding team using the Student's t-test and Fisher's exact test. Results The study encompassed 28 patients before and 39 after the implementation of the surveillance rounds. Significant reductions were observed in the number of dislocations (from 28.6% to 0%, p = 0.001) and local infections (from 17.9% to 2.6%, p = 0.04). While the decreases in thrombosis, catheter breakage/rupture, and catheter-related bloodstream infections (CRBSIs) did not reach statistical significance, they suggest a favorable trend toward enhanced management of CVADs. Conclusions The establishment of a pediatric CVAD surveillance and rounding team significantly reduced the incidence of dislocations and local infections among pediatric cancer patients with CVADs. This multidisciplinary team approach highlights the importance of continuous surveillance, teamwork, and education in enhancing the quality of CVAD care, contributing to safer patient outcomes and emphasizing the need for continuous improvement in pediatric CVAD management.

Keywords: bedside rounding; central venous access; central venous access device; central venous catheter (cvc); central venous line; children's; complication of central line.