The Impact on Professionals When Children Develop Central-Line Infections

Background/Objectives

Central-line associated bloodstream infections (CLABSIs) are a form of healthcare associated infection (HCAI) with devastating consequences for patients. Although the clinical outcomes of CLABSI are well-described, the impact on professionals who are involved in these events, and thus their ability to convey the severity of the condition has not been investigated.

Design/Methods

Semi-structured interviews were conducted with fifteen multi-disciplinary professionals who had experience of caring for children who had developed CLABSI. Interviews were digitally recorded and transcribed verbatim. Data were analysed using the constant comparative method. Results

Although CLABSI were familiar occurrences for healthcare professionals (HCPs) in this study, they were still traumatic events. They reported their experience of children with significant CLABSI becoming more unwell, more dramatically than other children. Further, memories of other children who had died as a result of CLABSI made the HCPs fearful that each subsequent child in their care would also die despite optimal treatment. They described significant emotional turmoil associated with making clinical decisions about the child’s care. Additionally, they felt that colleagues without personal experience of CLABSI were unable to appreciate the severity of the child’s condition, compared to other cases of sepsis. As a result, they often struggled to explain to their peers how unwell the child was. They believed this contributed to delays in accessing external support such as admissions to PICU or surgical removal of central lines.

Conclusions

CLABSI are emotionally traumatic events for HCPs, leaving significant residual emotional impact of each case. The HCPs experience of CLABSI compared to its understanding to those who had not cared for children with CLABSI, made it difficult to adequately communicate with colleagues. This risks delays to the child’s care. A wider education on the severity and impact of CLABSI amongst allied specialties could improve awareness and may improve speed of access to potentially life-saving interventions.