A multi-site quality improvement initiative led by the Division of Neonatal-Perinatal Medicine in the UNC School of Medicine demonstrated a 71 percent drop in the number of central line-associated bloodstream infections (CLABSIs) in newborns in neonatal intensive care units (NICUs) in 13 North Carolina NICUs—accomplished in less than a year’s time.
CLABSIs are the most costly and deadly hospital-acquired infections. Newborns, particularly premature infants admitted to NICUs, are at considerable risk, as their care often requires a central line remain in place for weeks, even months, providing clinicians a means to administer medication and nutrients directly into the bloodstream until the baby is well enough to function independently.
The PQCNC CLABSI initiative employed a collaborative structure targeting team development through monthly webinars and quarterly face-to-face learning sessions, family partnerships, and strict reporting on line care, producing the largest reduction in CLABSI rates for any multi-institutional NICU collaborative. CLABSI rates decreased from 3.94 infections per 1000 line days to 1.16 infections per 1000 line days with sustainment one year later, avoiding 110 infections annually and saving the lives an estimated 17 newborns a year.
“The takeaway is that, working in a collaborative framework, we can affect dramatic improvements in care and outcomes in a short period of time, much shorter than one might typically assume,” said Martin McCaffrey, MD, professor of pediatrics in the UNC School of Medicine and director of the Perinatal Quality Collaborative of North Carolina (PQCNC), the statewide, UNC-led collaborative which championed the project. “And as we see in this study, those improvements can more than pay for themselves and are worth the investment of time and resources.”
The study, entitled "Reducing Central Line-Associated Bloodstream Infections in North Carolina NICUs," was published in the December 2013 edition of Pediatrics, official journal of the American Academy of Pediatrics (AAP). Full article>>