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Published on: July 13, 2019
Decreasing central line associated bloodstream infection in neonatal intensive care
Richard J Powers1, David W Wirtschafter
1Good Samaritan Hospital, Newborn Intensive Care Unit, Pediatrix Neonatology Medical Group of San Jose, 3880 South Bascom Avenue, Suite 208, San Jose, CA 95124, USA. richard_powers@pediatrix.com
Insights
Central Line Associated Bloodstream Infections (CLABSIs) are preventable adverse events in neonatal intensive care units. This review summarizes evidence-based strategies and implementation methods to reduce CLABSI rates.
Area of Science:
- Healthcare Quality Improvement
- Infectious Disease Prevention
- Neonatal Medicine
Background:
- Central Line Associated Bloodstream Infections (CLABSIs) are significant causes of morbidity and mortality in neonatal intensive care units.
- CLABSIs are recognized as preventable adverse events linked to procedural technique and care practices.
- These infections can lead to severe, lifelong complications for affected newborns.
Purpose of the Study:
- To review evidence-based strategies for reducing CLABSI in the neonatal intensive care unit.
- To discuss the implementation of these strategies in bundled approaches.
- To highlight successful quality improvement initiatives and the factors influencing change in this setting.
Main Methods:
- Literature review of evidence-based strategies for CLABSI reduction over recent decades.
- Analysis of successful quality improvement collaboratives implementing bundled interventions.
- Examination of implementation science principles within the neonatal intensive care unit context.
Main Results:
- Multiple evidence-based strategies exist to effectively reduce CLABSI rates.
- Bundled implementation of interventions has demonstrated success in quality improvement collaboratives.
- Successful implementation requires understanding scientific data, technical advancements, and change management within the NICU.
Conclusions:
- CLABSI prevention is achievable through systematic application of evidence-based strategies.
- Bundled approaches and quality improvement collaboratives are effective models for reducing CLABSI.
- Effective implementation necessitates a multidisciplinary approach addressing technical and behavioral factors in the NICU.
Abstract:
Central Line Associated Bloodstream Infections (CLABSIs) have come to be recognized as preventable adverse events that result from lapses in technique at multiple levels of care. CLABSIs are associated with increased mortality and adverse outcomes that may have lifelong consequences. This review provides a summary of evidence-based strategies to reduce CLABSI in the newborn intensive care unit that have been described in the literature over the past decades. Implementation of these strategies in "bundles" is also discussed, citing examples of successful quality improvement collaboratives. The methods of implementation require an understanding of the scientific data and technical developments, as well as knowledge of how to influence change within the unique and complicated milieu of the newborn intensive care unit.
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