Central line associated bloodstream infections (CLABSI) in neonatal intensive care is associated with mortality, morbidity, increased length of stay and increased healthcare costs. Implementing a bundle of evidence-based interventions, continual audit and improvement and education and promotion of this led to a significant reduction in CLABSI rates and 157 consecutive CLABSI-free days.
Reducing central line-associated bloodstream infection rates
Initiative Type
Clinical Guideline
Status
Deliver
Added
Last updated
Summary
Key dates
Feb 2020
Feb 2020
Implementation sites
Mater Neonatal Critical Care Unit
Partnerships
Multidisciplinary NCCU team working together
Aim
To maintain CLABSI rates below recommended benchmark of 3 per 1,000 catheter days in the Mater Children's Hospital Neonatal Intensive Care Unit.
Benefits
- Large reduction in CLABSI, achieving the goal in the second year of the project
- Reducing infection reduces mortality, morbidity and healthcare costs
- Parents appreciated keeping their baby infection free
Background
Central venous line associated bloodstream infections (CLABSI) in neonatal intensive care is associated with mortality, morbidity, increased length of stay and increased healthcare costs.
Solutions Implemented
Intensive sentinel event base reviews of all CLABSI events to learn lessons and improve practice
Reporting of rates to the Neonatal Critical Care Unit (NCCU) team and executive monthly presentations.
Bundles of care for all central lines, new equipment, hand hygiene audit and education, "scrub the hub" technique.
Evaluation and Results
Monthly audit of CLABSI rates:
- per 1,000 catheter line days
- total number of infections per admission at various gestational age groups and birth weights
- number of days without a CLABSI
Sentinel review of process for all cases of results:
From May to September 2019 the NCCU went CLABSI free for 157 consecutive days and the rates decreased from 4.7 per 1,000 catheter line days in 2018 to 2.939 per 1,000 catheter line days year to date for 2019.
Lessons Learnt
Maintaining the level of vigilance and constant adherence to the processes requires a lot of energy and effort.
