Needleless Access Disinfection Standardization Improves Compliance and Decreases Central-line Associated Infections Within Pediatric and Neonatal Intensive Care Units

2016 ◽  
Vol 21 (4) ◽  
pp. 254
Author(s):  
Deborah Quast ◽  
Belinda Bordeaux
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Neonatal Intensive Care ◽  
Central Line ◽  
Neonatal Intensive Care Units

scholarly journals Central Line-Associated Bloodstream Infections in Neonatal Intensive Care Units

2012 ◽  
Vol 17 (suppl_A) ◽  
pp. 15A-15A
Author(s):  
AC Blanchard ◽  
E Fortin ◽  
I Rocher ◽  
D Moore ◽  
C Frenette ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Neonatal Intensive Care ◽  
Bloodstream Infections ◽  
Central Line ◽  
Neonatal Intensive Care Units

scholarly journals Assessment of the Reported Effectiveness of Five Different Quality- Improvement Initiatives for the Prevention of Central Line-Associated Bloodstream Infections in Intensive Care Units

2012 ◽  
Vol 5 (1) ◽  
pp. 5-12 ◽  
Author(s):  
Lawrence F. Muscarella
Keyword(s):  
Intensive Care ◽  
Quality Improvement ◽  
Intensive Care Units ◽  
Neonatal Intensive Care ◽  
Bloodstream Infections ◽  
Central Line ◽  
Qualitative Assessment ◽  
Neonatal Intensive Care Units ◽  
Cautious Interpretation

Five studies that evaluated five different quality-improvement initiatives for the prevention of central line-associated bloodstream infections (CLABSIs) in adult, pediatric and/or neonatal intensive care units (ICUs) and that were published within the past two years in an infection-control and epidemiology journal were reviewed, assessed and compared. Each is a prospective cohort study that similarly concludes that the evaluated initiative was responsible for a significant and calculated reduction in the CLABSI rate, ranging from 30.3% to 85%. The soundness of these conclusions and calculations, however, like the legitimacy of several other common uses of CLABSI data, requires, in addition to satisfying a number of other criteria, that each study's CLABSI rates be accurate and complete. The primary goal of this analysis, therefore, was to confirm the hypothesis that each of these five studies had validated its CLABSI rates. The analysis found, however, that these five studies did not validate the accuracy and completeness of their CLABSI rates, which raises reasonable questions about each study’s assessment of and conclusions about the initiative's effectiveness for the prevention of CLABSIs. In addition to their aims, calculations, and conclusions, these five studies share in common a number of features, as well as circumscribing qualities, which are discussed. The distinction between a qualitative assessment and a quantitative determination of an initiative's performance is also discussed. Both the circumspective use of CLABSI data that have not been validated and the cautious interpretation of conclusions about central-line care that are based on these CLABSI data are recommended.

Central Line–Associated Bloodstream Infection in Neonatal Intensive Care Units

2013 ◽  
Vol 34 (11) ◽  
pp. 1167-1173 ◽  
Author(s):  
Ana C. Blanchard ◽  
Elise Fortin ◽  
Isabelle Rocher ◽  
Dorothy L. Moore ◽  
Charles Frenette ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Neonatal Intensive Care ◽  
Case Fatality ◽  
Bloodstream Infections ◽  
Central Line ◽  
Incidence Rates ◽  
Neonatal Intensive Care Units ◽  
Surveillance Program ◽  
Utilization Ratio

Objective.Describe the epidemiology of central line-associated bloodstream infections (CLABSIs) in neonatal intensive care units (NICUs) participating in a standardized and mandatory CLABSI surveillance program.Design.Retrospective cohort.Setting.We included patients admitted (April 2007-March 2011) to 7 level II/III NICUs who developed a CLABSI (as defined by the National Healthcare Safety Network).Methods. CLABSIs/1,000 central line–days and device utilization ratio were calculated; x2 test, Student t test, Kruskal-Wallis, and Poisson regression were used.Results.Overall, 191 patients had 202 CLABSI episodes for a pooled mean rate of 4.0 CLABSIs/1,000 central line-days and a device utilization ratio of 0.20. Annual pooled mean CLABSI rates increased from 3.6 in 2007-2008 to 5.1 CLABSIs/1,000 central line-days in 2010-2011 (P = .01). The all-cause 30-day case fatality proportion was 8.9% (n = 17) and occurred a median of 8 days after CLABSI. Coagulase-negative Staphylococcus was identified in 112 (50.5%) cases. Staphylococcus aureus was identified in 22 cases, and 3 (13.6%) were resistant to methicillin. An underlying intra-abdominal pathology was found in 20% (40/202) of CLABSI cases, 50% of which were reported in the last year of study. When adjusted for mean birth weight, annual CLABSI incidence rates were independently associated with the proportion of intra-abdominal pathology (P = .007) and the proportion of pulmonary pathology (P = .016) reported.Conclusion.The increase in CLABSI rates in Quebec NICUs seems to be associated with an increased proportion of cases with underlying intra-abdominal and pulmonary pathologies, which needs further investigation.

scholarly journals The Association of State Legal Mandates for Data Submission of Central Line–Associated Bloodstream Infections in Neonatal Intensive Care Units with Process and Outcome Measures

2014 ◽  
Vol 35 (9) ◽  
pp. 1133-1139 ◽  
Author(s):  
Philip Zachariah ◽  
Julie Reagan ◽  
E. Yoko Furuya ◽  
Andrew Dick ◽  
Hangsheng Liu ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Outcome Measures ◽  
Neonatal Intensive Care ◽  
Bloodstream Infections ◽  
Central Line ◽  
Neonatal Intensive Care Units ◽  
Data Submission ◽  
Legal Mandates ◽  
Process And Outcome

ObjectiveTo determine the association between state legal mandates for data submission of central line–associated bloodstream infections (CLABSIs) in neonatal intensive care units (NICUs) with process and outcome measures.DesignCross-sectional study.Participants. National sample of level II/III and III NICUs participating in National Healthcare Safety Network (NHSN) surveillance.MethodsState mandates for data submission of CLABSIs in NICUs in place by 2011 were compiled and verified with state healthcare-associated infection coordinators. A web-based survey of infection control departments in October 2011 assessed CLABSI prevention practices, ie, compliance with checklist/bundle components (process measures) in ICUs including NICUs. Corresponding 2011 NHSN NICU CLABSI rates (outcome measures) were used to calculate standardized infection ratios (SIRs). Association between mandates and process and outcome measures was assessed by multivariable logistic regression.ResultsAmong 190 study NICUs, 107 (56.3%) were located in states with mandates, with mandates in place >3 years in 52 (49%). More NICUs in states with mandates reported ≥95% compliance to at least 1 CLABSI prevention practice (52.3%–66.4%) than NICUs in states without mandates (28.9%–48.2%). Mandates were predictors of ≥95% compliance with all practices (odds ratio, 2.8; 95% confidence interval, 1.4–6.1). NICUs in states with mandates reported lower mean CLABSI rates in the ≤750-g birth weight group (2.4 vs 5.7 CLABSIs/1,000 central line–days) but not in others. Mandates were not associated with SIR <1.ConclusionsState mandates for NICU CLABSI data submission were significantly associated with ≥95% compliance with CLABSI prevention practices, which declined with the duration of mandate but not with lower CLABSI rates.Infect Control Hosp Epidemiol 2014;35(9):1133-1139

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