Abstract
Objective:
To determine the association of a central-line maintenance team on the incidence of central-line-associated bloodstream infections (CLABSIs) in the neonatal intensive care unit (NICU).
Study Design:
Central line maintenance in the NICU was limited to a line team starting in March 2008. CLABSI rates were determined before (December 2006 to February 2008) and after implementation of the line team ( March 2008 to August 2010) utilizing consistent National Healthcare Safety Network definitions. Rates were calculated by birth weight categories and overall. Data analysis was performed by two-proportion t test using Minitab.
Result:
Overall CLABSI decreased by 65% after implementation of the line team. Pre intervention, mean overall CLABSI rate was 11.6 /1000, as compared with 4.0/1000 after intervention (P<0.001). Birth-weight-specific CLABSI rates also decreased significantly. Decreased infection rates were sustained over time.
Conclusion:
A line team provided for standardized, consistent central-line maintenance care leading to a significant, sustained decrease in CLABSI in a NICU.
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References
Marschall J, Mermel LA, Classen D, Arias KM, Podgorny K, Anderson DJ et al. Strategies to prevent central line-associated bloodstream infections in acute care hospitals. Infect Control Hosp Epidemiol 2008; 29: 522–530.
Couto RC, Pedrosa TM, Tofani C, Pedroso ER . Risk factors for nosocomial infection in a neonatal intensive care unit. Infect Control Hosp Epidemiol 2006; 27: 571–575.
O’Grady NP, Alexander M, Burns LA, Dellinger P, Garland J, Heard SO et al. Guidelines for the prevention of intravascular catheter-related infections. Clin Infect Dis 2011; 52: e162–e193.
Provonost P, Needham D, Bernholtz S, Sinopoli D, Chu H, Cosgrove S et al. An Intervention to decrease catheter-related bloodstream infections in the ICU. NEJM 2006; 355 (26): 2725–2732.
Costello JM, Morrow DF, Graham DA, Potter-Byone G, Sandora TJ, Laussen PC . Systematic intervention to reduce central line-associated bloodstream infection rates in a pediatric cardiac intensive care unit. Pediatrics 2008; 121 (5): 915–923.
Miller MR, Griswold MJ, Harris M, Yenokyan GW, Huskins C, Moss M et al. Decreasing PICU catheter-associated bloodstream infections: NACHRI's Quality transformation efforts. Pediatrics 2010; 125 (2): 206–213.
Schulman J, Stricof R, Stevens TP, Horgan M, Gase K, Holzman IR et al. Statewide NICU central-line-associated bloodstream infection rates decline after bundles and checklists. Pediatrics 2011; 127 (3): 436–444.
Kaplan HC, Lannon C, Walsh MC, Donovan EF . Ohio statewide quality-improvement collaborative to reduce late-onset sepsis in preterm infants. Pediatrics 2011; 127 (3): 427–435.
Wirtschafter DD, Powers RJ, Pettit JS, Lee HC, Boscardin WJ, Subeh MA et al. Nosocomial infection reduction in VLBW infants with a statewide quality-improvement model. Pediatrics 2011; 127 (3): 419–426.
Curry S, Honeycutt M, Goins G, Giliam C . Catheter-associated bloodstream infections in the NICU: getting to zero. Neonatal Network 2009; 28 (3): 151–155.
Soifer NE, Borzak S, Edlin BR, Weinstein RA . Prevention of peripheral venous catheter complications with an intravenous therapy team. Arch Intern Med 1998; 158: 473–477.
Meier PA, Fredrickson M, Catney M, Nettleman MD . Impact of a dedicated intravenous therapy team on nosocomial bloodstream infection rates. Am J Infect Control 1998; 26: 388–392.
Miller JM, Goetz AM, Squier C, Muder RR . Reduction in nosocomial intravenous device-related bacteremias after institution of an intravenous therapy team. J Intra Nurs 1996; 19: 103–106.
Brunelle D . Impact of a dedicated infusion therapy team on the reduction of catheter-related nosocomial infections. J Infus Nurs 2003; 26: 362–366.
Horan TC, Gaynes RP . Surveillance of nosocomial infections. Misc: In: Mayhall CG (ed). Hospital Epidemiology and Infection Control, 3rd edn. Lippincott Williams & Wilkins: Philadelphia, 2004, pp 1659–1702.
Horan TC, Andrus M, Dudeck MA . CDC/NHSN Surveillance definitions of healthcare associated infection and criteria for specific types of infections in the acute care setting. Am J Infect Control 2008; 36: 309–332.
Edwards JR, Peterson KD, Banerjee S, Allen-Bridson K, Morrell G, Dudeck MA et al. National healthcare safety network (NHSN) report: data summary for 2006 through 2008, issued december 2009. Am J Infect Control 2009; 37: 783–805.
Lee TW, Ko YK . Effects of self-efficacy, affectivity and collective efficacy on nursing performance of hospital nurses. J Advan Nurs 2010; 66: 839–848.
Robert J, Fridkin SK, Blumberg HM, Anderson B, White N, Ray SM et al. The Influence of the composition of the nursing staff on primary bloodstream infection rates in a surgical intensive care unit. Infect Control Hosp Epidemiol 2000; 21: 12–17.
Acknowledgements
We would like to acknowledge Kathy Masters MSRD, Kathy Luther RN, MPM and Amit Pazgal, PhD for their assistance in data analysis.
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Presented in Part at the Society for Healthcare Epidemiology of America National Conference, 2009.
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Holzmann-Pazgal, G., Kubanda, A., Davis, K. et al. Utilizing a line maintenance team to reduce central-line-associated bloodstream infections in a neonatal intensive care unit. J Perinatol 32, 281–286 (2012). https://doi.org/10.1038/jp.2011.91
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DOI: https://doi.org/10.1038/jp.2011.91
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