Evidence map›Paper›PMID 39505114›Full record

ArticleAmerican journal of infection control2025

Identifying high-risk central lines in critically ill children: A novel nurse-driven screening and mitigation intervention to reduce CLABSI.

Stephanie Morgenstern, Katie Thompson, Stephanie Panton, Vivian Donnelly, Sara Pau, Kat Nelson, Lauren Booth, Taylor McIlquham, Jessica Kitlas, Christina Schumacher and 3 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in American journal of infection control, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Treatment response evaluation in anFrontiers in pediatrics · 2025
    Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Stephanie MorgensternDepartment of Pediatric Nursing, Johns Hopkins Hospital, Baltimore, MD. Electronic address: Smorgen2@jh.edu.
Katie ThompsonDepartment of Pediatric Nursing, Johns Hopkins Hospital, Baltimore, MD.
Stephanie PantonDepartment of Pediatric Nursing, Johns Hopkins Hospital, Baltimore, MD.
Vivian DonnellyDepartment of Hospital Epidemiology and Infection Control, Johns Hopkins Hospital, Baltimore, MD.
Sara PauDepartment of Hospital Epidemiology and Infection Control, Johns Hopkins Hospital, Baltimore, MD.
Kat NelsonDepartment of Pediatric Nursing, Johns Hopkins Hospital, Baltimore, MD.
Lauren BoothDepartment of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
Taylor McIlquhamDepartment of Hospital Epidemiology and Infection Control, Johns Hopkins Hospital, Baltimore, MD.
Jessica KitlasDepartment of Pediatric Nursing, Johns Hopkins Hospital, Baltimore, MD.
Christina SchumacherDepartment of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD.
Aaron M MilstoneDepartment of Hospital Epidemiology and Infection Control, Johns Hopkins Hospital, Baltimore, MD; Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD; Armstrong Institute of Patient Safety and Quality, Johns Hopkins University School of Medicine, Baltimore, MD.
Meghan BernierDepartment of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD.
Anna C Sick-SamuelsDepartment of Hospital Epidemiology and Infection Control, Johns Hopkins Hospital, Baltimore, MD; Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD; Armstrong Institute of Patient Safety and Quality, Johns Hopkins University School of Medicine, Baltimore, MD.

Funding

Mentoring in prevention of hospital-acquired infections and antibiotic resistanceK24AI141580 · NIAID · JOHNS HOPKINS UNIVERSITY · PI AARON M MILSTONE · 2019 to 2026
$1.4M
Optimizing Respiratory Culture Practices for Mechanically Ventilated ChildrenK23HL161449 · NHLBI · JOHNS HOPKINS UNIVERSITY · PI Anna Sick-Samuels · 2022 to 2026
$992k
NHLBI NIH HHS K23 HL161449NIAID NIH HHS K24 AI141580
6 · The paper itself

Abstract

backgroundDespite strong adherence to central line-associated bloodstream infection (CLABSI) infection prevention bundles, the CLABSI rate in our academic pediatric intensive care unit (PICU) and pediatric cardiac intensive unit (PCICU) remained high.

methodsWe developed a novel screening tool that stratified patients' risk for CLABSI and considered risk mitigation strategies.

resultsOf 1,583 screenings, 30% were classified as high-risk, 27% as moderate-risk, and 43% as low-risk. With accurate screening, the tool was 100% sensitive to patients who developed CLABSI, with a negative predictive value of 100% for low-risk screens. The CLABSI rate declined from 1.83 per 1,000 catheter-days to 0.98 and 1.02 in 2021 and 2022, respectively, with unprecedented consecutive months CLABSI-free. Device utilization was stable across both units, declining by 19% in the PICU and rising in the PCICU with increased cardiac surgeries. Clinicians expressed increased awareness of patient CLABSI risk factors and mitigation strategies in surveys. DISCUSSION: This novel screening tool effectively identified high-risk patients to target resources and promoted improvements in CLABSI prevention processes in the PICU and PCICU.

conclusionsA novel nurse-driven CLABSI risk factor screening tool identified and focused resources on patients at high-risk for CLABSI, and increased awareness and proactive risk mitigation by clinicians.

Indexed as

Catheterization, Central VenousCatheter-Related InfectionsInfection ControlMass ScreeningAdolescentChildChild, PreschoolCritical IllnessCross InfectionFemaleHumansInfantInfant, NewbornIntensive Care Units, PediatricMaleNursesCentral lineInfectionPediatricPediatric intensive carePICURisk factors

Identifiers

PMID39505114
PMCPMC11874062

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.