Related Experiment Video
Updated: May 29, 2026
A Neonatal Imaging Model of Gram-Negative Bacterial Sepsis
Published on: August 12, 2020
Central line-associated bloodstream infections in neonatal intensive care: changing the mental model from
Gautham K Suresh1, William H Edwards
1Department of Pediatrics, Dartmouth Medical School, Lebanon, New Hampshire, USA. gautham.suresh@hitchcock.org
Insights
Health care-associated infections in neonates are preventable medical errors. Implementing strategies like strict sterile procedures and improved hygiene can significantly reduce central line-associated bloodstream infections (CLABSI) in neonatal intensive care units (NICUs).
Area of Science:
- Neonatal intensive care
- Infection prevention and control
- Patient safety
Background:
- Health care-associated infections in neonates were once considered unavoidable but are now recognized as preventable medical errors.
- These infections cause significant morbidity and mortality in newborns, highlighting the need for improved patient safety.
- Central line-associated bloodstream infections (CLABSI) are a major concern in neonatal intensive care units (NICUs).
Purpose of the Study:
- To emphasize the importance of preventing central line-associated bloodstream infections (CLABSI) in neonatal intensive care units (NICUs).
- To promote a shift in perspective, viewing CLABSIs as preventable complications rather than inevitable outcomes.
- To outline general and specific strategies for CLABSI prevention in neonates.
Main Methods:
- Adopting a mental model that CLABSIs are preventable.
- Implementing general infection prevention strategies: promoting safety culture, hand hygiene, adequate staffing, breast milk feeding, and family involvement.
- Implementing specific CLABSI prevention strategies: sterile insertion, aseptic maintenance, and timely catheter removal.
Main Results:
- The study outlines a comprehensive approach to CLABSI prevention in NICUs.
- Key strategies include strict adherence to sterile techniques during catheter insertion and maintenance.
- Early removal of central lines and participation in quality improvement collaboratives are crucial for reducing CLABSI rates.
Conclusions:
- CLABSIs are preventable and should be a top patient safety priority in NICUs.
- A multi-faceted approach combining organizational culture change, staff empowerment, and specific clinical practices is essential.
- Quality improvement collaboratives offer a promising avenue for enhancing CLABSI prevention efforts.
Abstract:
Previously considered unavoidable complications of hospital care (reflecting an "entitlement" mental model), health care-associated infections are now considered as medical errors and cause significant preventable morbidity and mortality in neonates. Prevention of such infections, particularly central line-associated bloodstream infections (CLABSI), should be an important patient safety priority for all neonatal intensive care units (NICUs). An important first step is to promote a mental model of CLABSIs as preventable complications of care. Other general strategies are (1) promoting an organizational culture of safety and empowerment of staff; (2) hand hygiene; (3) avoiding overcrowding and understaffing; (4) using breast milk for enteral feedings; and (5) involving families in infection prevention efforts. Specific strategies to prevent CLABSI are (1) insertion practices: insertion of all central vascular catheters under strict sterile conditions with the aid of a checklist; (2) maintenance practices: ensuring that entries into the lumen of the vascular catheter always occur under aseptic conditions, minimizing catheter disconnections, and replacement of intravenous infusion sets at recommended intervals; (3) removal of all central lines as soon as possible. Participation in national or statewide quality improvement collaboratives is an emerging trend in neonatology that can enhance CLABSI prevention efforts by NICUs.
Related Concept Videos
01:22Healthcare Associated Infections II: Preventive Measures
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
01:26Healthcare Associated Infections I: Iatrogenic, Exogenic and Endogenic
HAIs significantly increase the cost of health care. Extended stays in healthcare institutions, increased disability, increased costs of medications, including specialized antibiotics, and prolonged recovery times add to the patient's expenses and the healthcare institution and funding bodies. Common...
01:20Infection
The chain begins with pathogens: bacteria, viruses, fungi, prions, or parasites such as protozoa helminths. These can be present on the skin as transient or resident flora, or they can be acquired from the environment. Identifying and treating the type of infection and...
01:26Factors Affecting the Risk of Infection
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin create...
01:30Pneumonia V: Nursing management and Prevention
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed.