Childhood Cancer & Blood Disorders Network

Previously the Hematology/Oncology Collaborative, this network engages in central line-associated blood stream infection (CLABSI) prevention work for ambulatory patients and other projects to improve the care of children with cancer and blood disorders.

Sixty percent of pediatric patients with cancer and blood disorders have long-term ambulatory central lines, and there are 2 to 2.5 times more ambulatory CLABSIs than inpatient CLABSIs in pediatric cancer patients. Implementing a care bundle in the ambulatory setting has been shown to reduce the rates of central-line associated bloodstream infections significantly. Line care maintenance in the ambulatory setting is performed by clinic nurses, home health nurses, and patients/families, so standardization of care and extensive training and follow-up with families are important infection prevention strategies.

CCBDN is the only program in the country focused on CLABSI prevention for ambulatory patients, with 56 units from 28 hospitals participating. Collaborative team members learn to implement the evidence-based bundles and vetted QI methods. Connecting with teams at many other hospitals reduces trial and error to find effective solutions. Participating hospitals leverage these skills and techniques beyond CLABSI prevention for broader issues such as hand hygiene, wound care, blood cultures, infusion practices, and more. Team members are able to train other hospital units on these practices. Participating physicians satisfy their ABP MOC Part 4 requirement and nurses obtain CE credit.

The network is very effective in CLABSI prevention, reducing inpatient rates by 29 percent and ambulatory rates by 7 percent. As of September 2015, network sites prevented an estimated 1,000 CLABSIs and 102 deaths, and saved an estimated $35 million. 


CHA is no longer enrolling hospitals. 



A recent Pediatric Blood & Cancer article shows the burden of care for central-line associated bloodstream infections (CLABSI) in cancer and blood disorder outpatients with compromised immune systems.