When central line-associated bloodstream infections persisted among cancer patients at Tampa (Fla.) General Hospital — even as the oncology unit met its quality bundles — Anna Daigle, BSN, RN, and her team set out to find out why. They discovered the causes were outside the bundle, in patients’ daily routines.
Bundles are short sets of evidence-based steps care teams follow each time they place or maintain a central line and are the standard defense against these infections.
Central line-associated bloodstream infections in Tampa General Hospital’s oncology unit came largely from waterborne and skin organisms, Ms. Daigle, director of patient services, critical care medicine and oncology, said during a Nov. 5 panel at Becker’s Fall 2026 Oncology Executive Summit in Chicago. At the same time, peripherally inserted central catheters and ports placed in the oncology unit accounted for about 6,000 device days a year, Ms. Daigle said.
Showers and suitcases
Many oncology patients are ambulatory and shower daily, with some protecting their lines with little more than a plastic bag and tape. The team tested potential solutions on the market and adopted the one it judged most effective, Ms. Daigle said, and eradicated the waterborne pathogens causing CLABSIs.
Skin organisms such as Staphylococcus aureus and Staphylococcus epidermidis posed a harder problem, one rooted in what patients bring for hospital stays that can last weeks.
“They come toting their suitcases with their blankets, their own pillow, pillowcases, neck pillows, teddy bears, pajamas, robes, and the list goes on,” Ms. Daigle said. “But they don’t have the means to wash these while they’re in the hospital.”
Tampa General now asks families of local patients to bring fresh clothes so pajamas are worn only one day, while robes and blankets from home are laundered every two days. Patients admitted directly to the hospital from farther away receive a flyer before arrival outlining what to pack and asking who will swap out their clothing.
With those changes, CLABSIs in the oncology unit fell 50% over the past year, Ms. Daigle said. In the ICU, where infections were largely gastrointestinal, results went further.
“We had 19 different points of change within that environment and reduced those infections to absolutely zero in the last year,” she said.
Less time in the hospital
Time in the hospital carries its own risks for cancer patients. On average, patients in the oncology unit move to a higher level of care about 9.2 days into an admission, most often because of neutropenic fever, septicemia or tumor lysis syndrome, Ms. Daigle said.
Tampa General’s hospital-at-home program offers stable patients an alternative.
“When we do have patients that are sick enough to be in the hospital, but med-surg status, we look for opportunities to provide the care in a more controlled setting,” Ms. Daigle said.
The program began with leukemia patients, the hospital’s highest-risk group, to limit their exposure inside the hospital. It has since expanded to other stable patients who need intravenous antibiotics, fluids, nutrition or blood products.
“We do want to get patients out into the home, keep them a little bit safe from contacts,” Ms. Daigle said.
Eligible patients within a 30-minute drive can receive care at home, while those farther away receive care in partner hotels, which many insurance companies support “because it’s cheaper to keep the patients out of the hospital,” she said.
More broadly, Tampa General has cut its readmission rates in half and is “approaching world class metrics,” Ms. Daigle said.
