Qualitative process evaluation of a central line-associated bloodstream infection (CLABSI) prevention team in the neonatal intensive care unit

2020 ◽  
Vol 48 (9) ◽  
pp. 987-992
Author(s):  
Stephanie Stroever ◽  
Kelley Boston ◽  
Misti Ellsworth ◽  
Paula Cuccaro ◽  
Sheryl McCurdy
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Bloodstream Infection ◽  
Process Evaluation ◽  
Neonatal Intensive Care ◽  
Central Line ◽  
Qualitative Process Evaluation

scholarly journals Targeting Risk Factors for the Control of Central Line-Associated Bloodstream Infection in the Neonatal Intensive Care Unit: A Single Tertiary Center Experience

2021 ◽  
Vol 28 (3) ◽  
pp. 116-123
Author(s):  
Jiyoon Jeong ◽  
Yoojin Kwun ◽  
Min-ju Kim ◽  
Sang-Ho Choi ◽  
Euiseok Jung ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
High Risk ◽  
Infection Control ◽  
Neonatal Intensive Care Unit ◽  
Bloodstream Infection ◽  
Neonatal Intensive Care ◽  
Central Line ◽  
High Risk Infants

Purpose: The aim of this study was to estimate the effect of targeting risk factors for the control of central line-associated bloodstream infection (CLABSI) among high-risk infants in a tertiary neonatal intensive care unit (NICU).Methods: Infants admitted to the NICU and diagnosed with CLABSI from January to December 2013 were eligible for inclusion to the study. The CLABSI group (n=47) was matched in a 1:2 ratio to the control group (n=94) based on gestational age, birth weight, and Score for Neonatal Acute Physiology-II. Risk factors for CLABSI were identified using the Cox proportional hazard model, and analysis of the effect of these risk factors targeting infection control was performed.Results: The risk factors associated with CLABSI were prolonged central line dwell days (adjusted hazard ratio [HR], 1.028; 95% confidence interval [CI], 1.011 to 1.045; P=0.001), use of a silicone catheter (adjusted HR, 5.895; 95% CI, 1.893 to 18.355; P=0.002), surgical treatment (adjusted HR, 3.793; 95% CI, 1.467 to 9.805; P=0.006), and less probiotic supplementation (adjusted HR, 0.254; 95% CI, 0.068 to 0.949; P=0.042). By targeting these risk factors with a quality improvement initiative, the mean CLABSI incidence rate per 1,000 catheter-days decreased from 6.6 to 3.1 (P=0.004).Conclusion: Targeting risk factors for infection control significantly reduced the rate of CLABSI among high-risk infants in the NICU.

The Effect of Education on Chlorhexidine Use in a Neonatal Intensive Care Unit

2017 ◽  
Vol 22 (3) ◽  
pp. 115-123 ◽  
Author(s):  
Janet Delong Pettit ◽  
Elizabeth Li Sharpe
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Quality Improvement ◽  
Neonatal Intensive Care Unit ◽  
Bloodstream Infection ◽  
Education Program ◽  
Neonatal Intensive Care ◽  
Central Line ◽  
Quality Improvement Project ◽  
Improvement Project

Abstract Background: Neonates are at greater risk for central-line-associated bloodstream infection due to prolonged vascular access for nutrition and medications. Skin antisepsis using chlorhexidine gluconate (CHG), particularly the formulation with alcohol (CHG/alcohol), during central line insertion and maintenance activities is a key clinical care process associated with central line-associated bloodstream infection reduction. One area of ongoing confusion for many clinicians is whether to adhere to the manufacturer's recommendations that CHG remain on the skin following the procedure to promote persistent microbicidal effects, or to foster product removal in hopes of preventing skin-related complications. Purpose: Determine the effect of a targeted education program on the knowledge and attitudes of nurses who place peripherally inserted central catheters in the neonatal intensive care unit regarding the use and removal of CHG antiseptic. Methods: A quasiexperimental presurvey/postsurvey quality improvement project recruited participants from the electronic mailing list of a national neonatal nursing organization. Results: There was a statistically significant deficiency in knowledge or misinformation related to the use of CHG/alcohol on the presurvey assessment. Eight questions reflecting knowledge consistent with most recent evidence were answered correctly only 11.4%–25.7% of the time, all of which were considered statistically significant. Following completion of the education program, a nearly 100% correct response rate on all but 3 postsurvey questions resulted. Conclusions: This quality improvement project demonstrated success in the ability to change knowledge surrounding the removal of CHG/alcohol from the skin of babies in a neonatal intensive care unit following completion of a targeted education program, and the effectiveness of targeted web-based educational programs.

P17.58 Nosocomial Bloodstream Infection in a Neonatal Intensive Care Unit

2006 ◽  
Vol 64 ◽  
pp. S99
Author(s):  
M.J. Hernández ◽  
C. Lapresta ◽  
T. Giménez-Júlvez ◽  
C. Montaño ◽  
J.L. Arribas
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Bloodstream Infection ◽  
Neonatal Intensive Care ◽  
Nosocomial Bloodstream Infection

scholarly journals Effect of implementing an Epicutaneo-Caval Catheter team in Neonatal Intensive Care Unit

2020 ◽  
pp. 112972982092818
Author(s):  
Mohammad A A Bayoumi ◽  
Matheus F P Van Rens ◽  
Prem Chandra ◽  
Airene L V Francia ◽  
Sunitha D’Souza ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Intervention Study ◽  
Central Line ◽  
Success Rates ◽  
Infection Rates ◽  
Umbilical Catheters ◽  
Dedicated Team

Background: Until the 1980s, central vascular access in the Neonatal Intensive Care Unit was predominantly delivered by umbilical catheters and only and if needed by surgical cutdowns or subclavian vein catheterization through blind percutaneous venipuncture. In the early 1980s, epicutaneo-caval catheters were successfully introduced. Methods: In our Neonatal Intensive Care Unit, a dedicated team to insert epicutaneo-caval catheters was formally established in January 2017, including 12 neonatologists and 1 neonatal nurse practitioner. A before- versus after-intervention study was designed to determine whether the establishment of the epicutaneo-caval catheter insertion team is associated with increased success rates and a decreased risk of catheter-related complications. Success rates and other catheter-related parameters were traced from 2016 onward. Collected data were analyzed for three consecutive years: 2016, 2017, and 2018. Results: The epicutaneo-caval catheter team inserted 1336 catheters over 3 years. Both first prick (from 57.7% to 66.9%; p = 0.023) and overall success (from 81.7% to 97.6%; p < 0.0001) rates significantly improved. In 2018, the number of tunneled or surgically inserted central venous catheters came down to zero (p < 0.0001). Overall catheter-related complications were significantly lower following the epicutaneo-caval catheter team’s establishment (p < 0.0001) while there was no significant decrease noted (p = 0.978) in central line–associated bacterial stream infection rates. Conclusion: A dedicated epicutaneo-caval catheter team is a promising intervention to increase success rates and significantly decrease catheter-related complications in Neonatal Intensive Care Unit. Standardizing epicutaneo-caval catheter placement is important; however, standardizing catheter maintenance seems essential to the improvement of central line–associated bacterial stream infection rates.

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