Reduction in Central Line-Associated Bloodstream Infection Rates After Implementations of Infection Control Measures at a Level 3 Neonatal Intensive Care Unit

Am J Med Qual. 2016 Mar-Apr;31(2):133-8. doi: 10.1177/1062860614557637. Epub 2014 Nov 4.

Abstract

Advances in neonatology led to survival of micro-preemies, who need central lines. Central line-associated bloodstream infection (CLABSI) causes prolonged hospitalization, morbidities, and mortality. Health care team education decreases CLABSIs. The objective was to decrease CLABSIs using evidence-based measures. The retrospective review compared CLABSI incidence during and after changes in catheter care. In April 2011, intravenous (IV) tubing changed from Interlink to Clearlink; IV tubing changing interval increased from 24 to 72 hours. CLABSIs increased. The following measures were implemented: July 2011, reeducation of neonatal intensive care staff on Clearlink; August 2011, IV tubing changing interval returned to 24 hours; September 2011, changed from Clearlink back to Interlink; November 2011, review of entire IV process and in-service on hand hygiene; December 2011, competencies on IV access for all nurses. CLABSIs were compared during and after interventions. Means were compared using the t test and ratios using the χ(2) test; P <.05. CLABSIs decreased from 4.4/1000 to 0/1000 catheter-days; P < .05. Evidence-based interventions reduced CLABSIs.

Keywords: Clearlink; Interlink; central line–associated bloodstream infection (CLABSI); evidence-based intervention; health care team education; intravenous tubing; quality improvement project.

MeSH terms

  • Birth Weight
  • Catheter-Related Infections / prevention & control*
  • Evidence-Based Medicine
  • Female
  • Gestational Age
  • Humans
  • Infant, Newborn
  • Infection Control / instrumentation
  • Infection Control / organization & administration*
  • Inservice Training
  • Intensive Care Units, Neonatal / organization & administration*
  • Male
  • Quality Improvement / organization & administration
  • Retrospective Studies
  • Time Factors