Significant Reduction of Central-Line Associated Bloodstream Infections in a Network of Diverse Neonatal Nurseries - 29/06/15
Abstract |
Objective |
To describe a quality improvement (QI) initiative that was associated with a dramatic reduction in neonatal central-line associated bloodstream infection (CLABSI) rate in a diverse group of 8 intensive care nurseries (Neonatal Services).
Study design |
A quasi-experimental time series QI initiative using the model for improvement and evidenced-based interventions.
Results |
The aggregate CLABSI rate for Nationwide Children's Hospital-associated Neonatal Services decreased from 6.0 CLABSI per 1000 catheter days to 1.43 CLABSI per 1000 catheter days in less than 2 years and has remained in control at 0.68 per 1000 catheter days for over 5 years. Each of 8 nurseries has had a 1 year or more CLABSI-free period, including the neonatal intensive care unit with the largest patient volume, acuity, and central line usage. Aggregate Neonatal Services has experienced 3 CLABSI-free quarters since 2007. Key success factors included: (1) engagement of senior executive leadership; (2) bedside “huddles” among clinical and epidemiology staffs conducted within 72 hours after a positive blood culture; (3) implementation of chlorhexidine antisepsis and the use of chlorhexidine-impregnated catheter site discs; and (4) and establishment of a dedicated team for percutaneously inserted central catheter insertion to serve units in which central lines are placed less frequently.
Conclusions |
Using the model for improvement and evidenced-based interventions, this QI project has been associated with reduction in the CLABSI rate by 89%, and over 430 CLABSIs likely have been avoided.
Le texte complet de cet article est disponible en PDF.Keyword : CLABSI, NCH, NHSN, NICU, QI, SCN
Plan
The authors declare no conflicts of interest. |
Vol 167 - N° 1
P. 41 - juillet 2015 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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