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(13) Decreasing CLABSIs with Standardized Blinatumomab Education

Location: Exhibit Hall D
Title: Decreasing CLABSIs with Standardized Blinatumomab Education

Abstract : In July 2024 COG announced the results of AALL 1731. In response to these amazing results, Children’s Hospital of Philadelphia added two cycles of blinatumomab to the standard treatment of on-therapy B ALL patients. This treatment consists of a 28-day infusion delivered in the outpatient setting after a short inpatient admission. Most of these patients do not have experience being at home with an accessed central line, which is a risk factor for Central Line Blood Stream Infections (CLABSI). We did see an increase in CLABSIs among ALL patients. CLABSIs cause increases in morbidity, mortality, length of hospital stays, and healthcare cost (Kemp et al., 2019). Given limitations of existing education, we identified a need to improve our education for patients and families guiding home management of blinatumomab infusions.

In partnership with CHOP Home Care, CHOP’s Family Learning Center and the leukemia/lymphoma nurse practitioners, the Oncology Patient/Family Education Specialist developed a comprehensive education plan. Written materials “Blinatumomab at Home” and “Blinatumomab Bag Changes” were created and are available in our teaching library. A foundation provided the money to buy 3 CADD pumps for education. All families are required to attend a 60-90 minute class that has a clear outline that is followed in all locations. Didactic material is covered in addition to families having hands on practice with dressing reinforcement, use of Valguard and Aqua guard. Families are taught how to trouble shoot issues and who to call with questions/concerns. Some families are taught to safely perform bag changes independently at home.

The implementation of this standardized education has had an extremely positive result. From July through October 2024, CHOP had 9 CLABSIs during 52 infusions of blinatumomab. Post implementation of our standardized education in November 2024, there have been no central line infections with 62 blinatumomab infusions.