{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T15:51:16Z","timestamp":1785772276120,"version":"3.56.0"},"reference-count":32,"publisher":"Cambridge University Press (CUP)","issue":"9","license":[{"start":{"date-parts":[[2020,6,4]],"date-time":"2020-06-04T00:00:00Z","timestamp":1591228800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S0899823X20002354_as1\" sec-type=\"other\"><jats:title>Objective:<\/jats:title><jats:p>To institute facility-wide Kamishibai card (K-card) rounding for central venous catheter (CVC) maintenance bundle education and adherence and to evaluate its impact on bundle reliability and central-line\u2013associated bloodstream infection (CLABSI) rates.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X20002354_as2\" sec-type=\"other\"><jats:title>Design:<\/jats:title><jats:p>Quality improvement project.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X20002354_as3\" sec-type=\"other\"><jats:title>Setting:<\/jats:title><jats:p>Inpatient units at a large, academic freestanding children\u2019s hospital.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X20002354_as4\" sec-type=\"other\"><jats:title>Participants:<\/jats:title><jats:p>Data for inpatients with a CVC in place for \u22651 day between November 1, 2017 and October 31, 2018 were included.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X20002354_as5\" sec-type=\"other\"><jats:title>Intervention:<\/jats:title><jats:p>A K-card was developed based on 7 core elements in our CVC maintenance bundle. During monthly audits, auditors used the K-cards to ask bedside nurses standardized questions and to conduct medical record documentation reviews in real time. Adherence to every bundle element was required for the audit to be considered \u201cadherent.\u201d We recorded bundle reliability prospectively, and we compared reliability and CLABSI rates at baseline and 1 year after the intervention.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X20002354_as6\" sec-type=\"other\"><jats:title>Results:<\/jats:title><jats:p>During the study period, 2,321 K-card audits were performed for 1,051 unique patients. Overall maintenance bundle reliability increased significantly from 43% at baseline to 78% at 12 months after implementation (<jats:italic>P<\/jats:italic> &lt; .001). The hospital-wide CLABSI rate decreased from 1.35 during the 12-month baseline period to 1.17 during the 12-month intervention period, but the change was not statistically significant (incidence rate ratio [IRR], 0.87; 95% confidence interval [CI], 0.60\u20131.24; <jats:italic>P<\/jats:italic> = .41).<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X20002354_as7\" sec-type=\"other\"><jats:title>Conclusions:<\/jats:title><jats:p>Hospital-wide CVC K-card rounding facilitated standardized data collection, discussion of reliability, and real-time feedback to nurses. Maintenance bundle reliability increased after implementation, accompanied by a nonsignificant decrease in the CLABSI rate.<\/jats:p><\/jats:sec>","DOI":"10.1017\/ice.2020.235","type":"journal-article","created":{"date-parts":[[2020,6,4]],"date-time":"2020-06-04T06:14:41Z","timestamp":1591251281000},"page":"1058-1063","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":20,"title":["Central venous catheter bundle adherence: Kamishibai card (K-card) rounding for central-line\u2013associated bloodstream infection (CLABSI) prevention"],"prefix":"10.1017","volume":"41","author":[{"given":"Jennifer A.","family":"Ormsby","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Cronin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane","family":"Carpenter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dionne A.","family":"Graham","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gail","family":"Potter-Bynoe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana M.","family":"Vaughan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lindsay","family":"Weir","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen A.","family":"Flaherty","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Celeste J.","family":"Chandonnet","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory P.","family":"Priebe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1755-5881","authenticated-orcid":false,"given":"Thomas J.","family":"Sandora","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2020,6,4]]},"reference":[{"key":"S0899823X20002354_ref32","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1016\/j.ajic.2013.11.016","article-title":"The role of tissue plasminogen activator use and systemic hypercoagulability in central-line\u2013associated bloodstream infections","volume":"42","author":"Thakarar","year":"2014","journal-title":"Am J Infect Control"},{"key":"S0899823X20002354_ref31","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0b013e318271f48a"},{"key":"S0899823X20002354_ref30","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2015.01.006"},{"key":"S0899823X20002354_ref27","unstructured":"27. IHI White Paper. Using care bundles to improve health care quality. Institute for Healthcare Improvement website. http:\/\/www.ihi.org\/resources\/Pages\/IHIWhitePapers\/UsingCareBundles.aspx. Published 2012. Accessed May 18, 2020."},{"key":"S0899823X20002354_ref25","doi-asserted-by":"publisher","DOI":"10.1016\/j.idc.2017.05.007"},{"key":"S0899823X20002354_ref23","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2015.09.015"},{"key":"S0899823X20002354_ref21","unstructured":"21. Jurecko, L . Kamishibai card rounding helps prevent hospital-acquired infections. Children\u2019s Hospital Association website. https:\/\/www.childrenshospitals.org\/newsroom\/childrens-hospitals-today\/issue-archive\/issues\/summer-2015\/articles\/lean-tools-help-prevent-hospital-acquired-infections. Published March 13, 2017. 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All rights reserved.","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}}]}}