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Healthcare Associated Infections II: Preventive Measures01:22

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Implementing a Sustainable, Phased Approach to Reducing CLABSI Rates in a Level IV NICU.

Sarah Velasco1, Alexandra Hamby, Figaro L Loresto

  • 1Author Affiliations: Children's Hospital Colorado, Aurora, Colorado (Drs Velasco, Hamby, Loresto, Bourque and Smith); University of Colorado College of Nursing, Aurora, Colorado (Dr Loresto); and University of Colorado School of Medicine, Aurora, Colorado (Drs Bourque and Smith).

Advances in Neonatal Care : Official Journal of the National Association of Neonatal Nurses
|March 24, 2026
PubMed
Summary
This summary is machine-generated.

A quality improvement project successfully reduced central line-associated bloodstream infections (CLABSIs) in a Level IV neonatal intensive care unit (NICU). The initiative decreased CLABSI rates by implementing evidence-based practices and interprofessional collaboration.

Keywords:
CLABSI reductionNICUbenchmarkcentral linecentral line careenvironment of careinfection preventionlevel IV NICUmultidisciplinaryneonatal

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Area of Science:

  • Neonatal Intensive Care Unit (NICU) Quality Improvement
  • Infection Prevention and Control
  • Healthcare-Associated Infections

Background:

  • Central line-associated bloodstream infections (CLABSIs) increase mortality and hospital stay.
  • Reducing CLABSIs in Level IV NICUs is challenging due to complex patient needs and care variability.

Purpose of the Study:

  • To decrease CLABSI rates in a Level IV NICU from a baseline of 2 infections per 1000-line days to less than 1 infection per 1000-line days.

Main Methods:

  • A nurse-led team benchmarked practices with high-performing NICUs.
  • Literature review informed recommendations for line care, product trials, and environmental improvements.
  • Interrupted time series analysis evaluated intervention effectiveness.

Main Results:

  • A phased implementation from September 2022 to April 2023.
  • Achieved a statistically significant decrease in CLABSI rates from 2.0 to 0.91 infections per 1000-line days (P = .02).

Conclusions:

  • CLABSI reduction is critical for Level IV NICU patient outcomes.
  • Benchmarking with other NICUs is a valuable strategy when specific research is limited.