Chances are that if your child needs to be admitted to a pediatric intensive-care unit, where he or she goes will depend mostly on which hospitals are closest, your doctor’s admitting privileges, your insurance coverage, and the expertise of the clinicians and the ICU. Still, in some cases when you do have a choice, knowing the units’ infection rates might help you decide. You can also consider that information when choosing a pediatrician. Ask which hospital your doctor admits patients to, and see how its pediatric ICU performed.
Even if you don’t have a choice, knowing those rates can help you determine how vigilant you need to be during your child’s stay. And regardless of its Rating, you can help prevent infections by taking the following steps:
• Ask the staff how you can help. The ICU staff will probably welcome your participation. Unlike a nurse, “a parent at the bedside isn’t going to have a couple of patients; they have just one,” says Marlene Miller, M.D., vice chairwoman of quality and safety at Johns Hopkins Children’s Center and a professor of pediatrics. “Helping to watch that the central line stays clean, and that everyone who touches it scrubs it clean and uses sterile equipment to access it, is ideal,” he says.
• Make sure the hospital follows best practices for inserting and maintaining central lines. Those measures include disinfecting the site and changing the dressings regularly, standardizing the procedures for changing the catheter caps and tubes, and developing readily available prepackaged kits with all the necessary tools to do those jobs right. But you don’t have to know each of the steps. Simply asking about them can remind staff to be extra vigilant about adhering to the safety measures.
• Ask if the central line is still needed. “That’s a question we are supposed to ask each other every day,” says Joel Cochran, D.O., who helps oversee infection prevention at the Medical University of South Carolina, one of our top-rated pediatric ICUs. “There’s no reason a parent shouldn’t ask it, too.”
• Keep hands clean. That means making sure you, visitors, and the hospital staff wash their hands with soap or an alcohol-based solution before touching your child or the catheter.
• Watch the catheter. The line can stray near your child’s diaper, for example, and children might fiddle or even put the lines in their mouth.
• Keep a journal. Keep track of how often hospital staff change the catheter or dressing and how long the catheter has been in.
• Raise an alarm. “If things don’t seem right, trust your instincts and say something—and make sure someone responds to you,” urges McGiffert of our Safe Patient Project. “I've heard too many stories of children who died because the parents trusted the hospital’s system. Don't let anything go. You know your child, and you are part of the team.”
• Share your story. If you or someone you care for has been harmed by a hospital-acquired infection, you can share it with our Safe Patient Project, which raises awareness about hospital safety.
See our hospital survival guide for more tips on staying safe in the hospital.