Reducing Central Line–Associated Bloodstream Infections in North Carolina NICUs

Author:

Fisher David1,Cochran Keith M.2,Provost Lloyd P.3,Patterson Jacquelyn2,Bristol Tara2,Metzguer Karen2,Smith Brian4,Testoni Daniela4,McCaffrey Martin J.2

Affiliation:

1. Department of Pediatrics, Levine Children’s Hospital at Carolinas Medical Center, Charlotte, North Carolina;

2. Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, North Carolina;

3. Associates in Process Improvement, Austin, Texas; and

4. Duke Clinical Research Institute, Durham, North Carolina

Abstract

OBJECTIVE: Central lines in NICUs have long dwell times. Success in reducing central line–associated bloodstream infections (CLABSIs) requires a multidisciplinary team approach to line maintenance and insertion. The Perinatal Quality Collaborative of North Carolina (PQCNC) CLABSI project supported the development of NICU teams including parents, the implementation of an action plan with unique bundle elements and a rigorous reporting schedule. The goal was to reduce CLABSI rates by 75%. METHODS: Thirteen NICUs participated in an initiative developed over 3 months and deployed over 9 months. Teams participated in monthly webinars and quarterly face-to-face learning sessions. NICUs reported on bundle compliance and National Health Surveillance Network infection rates at baseline, during the intervention, and 3 and 12 months after the intervention. Process and outcome indicators were analyzed using statistical process control methods (SPC). RESULTS: Near-daily maintenance observations were requested for all lines with a 68% response rate. SPC analysis revealed a trend to an increase in bundle compliance. We also report significant adoption of a new maintenance bundle element, central line removal when enteral feedings reached 120 ml/kg per day. The PQCNC CLABSI rate decreased 71%, from 3.94 infections per 1000 line days to 1.16 infections per 1000 line days with sustainment 1 year later (P = .01). CONCLUSIONS: A collaborative structure targeting team development, family partnership, unique bundle elements and strict reporting on line care produced the largest reduction in CLABSI rates for any multiinstitutional NICU collaborative.

Publisher

American Academy of Pediatrics (AAP)

Subject

Pediatrics, Perinatology, and Child Health

Cited by 98 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

1. Neonatal bacteremia and sepsis;Remington and Klein's Infectious Diseases of the Fetus and Newborn Infant;2025

2. Quality improvement initiative ‘S-A-F-H’ to reduce healthcare-associated neonatal sepsis in a tertiary neonatal care unit;BMJ Open Quality;2024-06

3. The entwined circles of quality improvement & advocacy;Seminars in Perinatology;2024-04

4. Care bundles and peripheral arterial catheters;British Journal of Nursing;2024-01-25

5. Initiation of interdisciplinary prevention rounds: decreasing CLABSIs in critically ill children;Antimicrobial Stewardship & Healthcare Epidemiology;2024

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3