Effect of a Quality Management System on Preventing Peripherally Inserted Central Catheter-Related Complications Among Pediatric Patients With Hematology Disorders.

BACKGROUND

Prolonged peripherally inserted central catheter (PICC) use in pediatric patients with hematologic disorders is associated with an elevated risk of central line-associated bloodstream infection (CLABSI), which can lead to poor outcomes and a mortality rate approaching 25%.

OBJECTIVE

To evaluate the effectiveness of the PICC-Quality Management System (QMS) in reducing CLABSI and PICC-related complications in pediatric hematologic patients.

METHODS

We conducted a single-center, pre-post intervention study including pediatric patients with PICC placement exceeding 48 hours. The 2023 cohort (n = 611) received conventional care, whereas the 2024 cohort (n = 693) received care under the PICC-QMS. Baseline demographics and clinical characteristics were comparable between groups.

RESULTS

A total of 1304 patients (mean age ± SD, 9.22 ± 0.11 years; 34.7% female) were analyzed. Compared with conventional care, PICC-QMS implementation was associated with lower CLABSI incidence (22 versus 13 cases; P = .06) and reduced thrombus formation (6 versus 1 case; P = .039). After adjustment for ward type, logistic regression indicated a significantly reduced CLABSI risk in the PICC-QMS group (adjusted odds ratio, 0.46; 95% CI, 0.20-0.90; P = .022).

CONCLUSIONS

The PICC-QMS effectively reduces CLABSI incidence in pediatric patients with hematologic disorders, underscoring its value as an infection control strategy.

IMPLICATIONS FOR ONCOLOGY NURSING PRACTICE: Standardization, refinement, and continuous monitoring under the PICC-QMS provide a practical, reproducible framework for integrating high-quality PICC care into routine practice, offering a potential reference model for other high-risk populations.