Sustaining SLUG Bug CLABSI Reduction: Does Sterile Tubing Change Technique Really Work?
Eugenia K Pallotto1, Anthony J Piazza2, Joan R Smith3
1Division of Neonatology, Department of Pediatrics, Children's Mercy Hospital, Kansas City, Missouri; ekpallotto@cmh.edu.
Pediatrics
|September 28, 2017
Summary
Sustaining low central line-associated bloodstream infection (CLABSI) rates in NICUs is achievable through collaboration. Implementing a sterile tubing change (TC) technique further reduced CLABSI rates by 64% in participating centers.
Area of Science:
- Healthcare Quality Improvement
- Infection Prevention
- Neonatal Intensive Care
Background:
- Central line-associated bloodstream infections (CLABSIs) pose significant risks in Neonatal Intensive Care Units (NICUs).
- Multicenter collaboratives have shown promise in reducing healthcare-associated infections.
- The sterile tubing change (TC) technique is a potential intervention for CLABSI reduction.
Purpose of the Study:
- To assess the sustainability of reduced CLABSI rates in NICUs within a multicenter collaborative.
- To evaluate the impact of the sterile TC technique on CLABSI rates.
Main Methods:
- A 12-month quality improvement collaborative involving Level IV NICUs to lower CLABSI rates.
- A subsequent 19-month sustain phase focusing on CLABSI rate monitoring.
- Adoption of the sterile TC technique by four centers during the sustain phase.
Main Results:
- The aggregate CLABSI rate of 1.076 per 1000 line days was sustained across 17 NICUs for 19 months.
- Centers adopting the sterile TC technique experienced a 64% reduction in CLABSI rates (from 1.59 to 0.57 per 1000 line days).
Conclusions:
- Sustaining low CLABSI rates is feasible with sustained team engagement and collaborative efforts.
- The sterile TC technique significantly contributes to CLABSI reduction in NICU settings.
