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Published on: July 13, 2019
A multidisciplinary intervention to reduce central line-associated bloodstream infection in pediatrics and neonatal
Wafaa Seddik Hamza1, Esam Ahmed-Taher Mahmoud Hamed2, Mariam Abdelrahman Alfadhli3
1Department of Public Health and Community Medicine, Faculty of Medicine, Assiut University, Egypt.
Insights
Implementing a quality improvement intervention significantly reduced central line-associated bloodstream infections (CLABSIs) in neonates and children. This initiative lowered infection rates and central line duration, improving patient outcomes in ICUs.
Area of Science:
- Healthcare-associated infections
- Pediatric critical care
- Infection prevention
Background:
- Central line-associated bloodstream infections (CLABSIs) are a leading cause of healthcare-associated infections in high-risk neonates and children.
- CLABSIs lead to extended hospital stays, increased costs, and higher mortality rates.
- Evidence-based interventions are crucial for reducing CLABSI rates.
Purpose of the Study:
- To decrease the high rate of CLABSIs in pediatric and neonatal intensive care units.
- To implement standardized quality improvement interventions for central line care.
- To reduce the incidence of healthcare-associated infections in vulnerable pediatric populations.
Main Methods:
- A pre-post-intervention study design was utilized.
- A multidisciplinary quality improvement intervention included a dedicated central line insertion team, bedside kits, and staff training.
- Auditing, checklist compliance, and monthly feedback were conducted over 12 months post-intervention.
Main Results:
- CLABSI rates decreased by 59.5%, from 7.5 to 3.0 per 1000 catheter-days.
- The duration of central line use was significantly reduced from 21.3 ± 9.9 to 11.0 ± 3.2 days (P < 0.05).
- Device utilization ratio was also monitored.
Conclusions:
- A multidisciplinary quality improvement intervention effectively reduced CLABSI rates in pediatric and neonatal ICUs.
- Key components included a central line care bundle, a dedicated IV team, and ongoing education with feedback.
- Standardized interventions are vital for controlling healthcare-associated infections in critical care settings.
Background:
To date, central line-associated bloodstream infections (CLABSIs) are the most common healthcare-associated infections in high-risk neonates and children. These infections are associated with significantly longer hospital stays, increased health care cost, and mortality in the health care systems. Application of evidence-based preventive interventions has proven to decrease CLABSI rate. The purpose of this study is to reduce the undesired relative high CLABSI rate through the adoption of standardized quality improvement interventions.
Methods:
and Methods: The study employed a pre-post-intervention design. Phase one is a retrospective calculation of 12 months of surveillance period as a baseline. Phase 2 establishes a multidisciplinary quality improvement intervention, which includes the formation of a dedicated central line insertion team, provision of central line kit at the bedside, training and educating the team, and selecting bundle checklist. In the third phase, we performed auditing and calculating the checklist compliance and monthly feedback for 12 consecutive post-intervention months. During phase 1 and 3, we calculated the following measures; CLABSI per 1000 catheter-days, duration of central line use, and device utilization ratio.
Results:
During the post-intervention phase the CLABSI rate significantly reduced by 59.5% from 7.5 to 3.0 per 1000 central line day, and the duration of use of the central line decreased from 21.3 ± 9.9 to 11.0 ± 3.2 days (P < 0.05).
Conclusion:
Implementation of quality improvement multidisciplinary intervention; central line insertion and maintenance care bundle, dedicated IV team, education and feedback effectively reduced the rate of CLABSI within our pediatrics and neonatal ICUs.
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