Reduction in Central Line-Associated Bloodstream Infection Rates After Implementations of Infection Control Measures...

Area of Science:

• Neonatology
• Infectious Disease Prevention
• Healthcare Quality Improvement

Background:

• Micro-preemies require central lines for survival, increasing their risk of central line-associated bloodstream infections (CLABSIs).
• CLABSIs lead to extended hospital stays, increased morbidity, and mortality in vulnerable neonates.
• Healthcare team education is a known factor in reducing CLABSIs.

Purpose of the Study:

• To decrease CLABSIs in a neonatal intensive care unit (NICU) by implementing and evaluating evidence-based interventions.
• To compare CLABSI incidence before and after specific changes in intravenous (IV) catheter care protocols.

Main Methods:

• A retrospective review was conducted to analyze CLABSI rates.
• Interventions included staff re-education on IV connectors, returning to a 24-hour IV tubing change interval, switching back to a previously used IV connector, and comprehensive staff training on hand hygiene and IV access competencies.
• Statistical analysis used the t-test for means and the chi-squared test for ratios, with a significance level of P < .05.

Main Results:

• Following initial changes to IV tubing (Interlink to Clearlink) and increased changing interval (24 to 72 hours), CLABSIs increased.
• After implementing re-education, returning to a 24-hour interval, switching back to Interlink connectors, and enhancing hand hygiene and IV access training, CLABSIs decreased significantly.
• The CLABSI rate dropped from 4.4 per 1000 catheter-days to 0 per 1000 catheter-days (P < .05).

Conclusions:

• Evidence-based interventions, including targeted staff education and optimized catheter care protocols, are effective in reducing CLABSIs in neonates.
• A multidisciplinary approach to infection control is crucial for improving patient safety in the NICU.
• Achieving a zero CLABSI rate is attainable through rigorous adherence to evidence-based practices.