When Allison Flanagan gets ready to flush and clean the external line in her chest, she dons a surgical mask and gloves and lays out her supplies with nurse-like precision. There are gauze pads, disinfectant swabs and saline tubes, and although she is just 15 she answers “No, I’m good” when asked by her instructor, nurse M. Denise Desrochers, whether she needs help.
“I just like doing it myself,” said the teenager from Haverill, Mass., who is being treated for an immune condition at Dana-Farber/Boston Children’s Cancer and Blood Disorders Center.
Allison is well aware of the risk of infection she faces after a stem cell transplant left her immune system and infection-fighting abilities so weakened that she must remain at home in isolation. “I feel more comfortable this way,” she adds.
Allison represents a critical frontier in safety training — patients and home caregivers who are being taught to handle complex tasks outside wards and clinics. The care might involve chemotherapy, dialysis, or IV nutrition, but the goal is the same: to keep the patient safe from conditions like central-line-associated bloodstream infections, or CLABSIs, which are among the most dangerous and preventable maladies they face.
And Allison’s eagerness to do the job herself makes her “a superstar,” Desrochers said. (For more on how Desrochers trains patients in central-line care, see “Five Questions.”)