Abstract | BACKGROUND: Central line-associated blood stream infections (CLABSIs) are common problems in neonatal intensive care units (NICUs). Implementation of catheter care bundles has been shown to reduce CLABSI rates. We developed a care bundle aiming at establishing a uniform central line insertion technique and improving teaching practices focusing on simulation-based techniques. The purpose of this study was to assess the impact of this care bundle on CLABSI rates in very low birth weight infants (VLBWI). METHODS: In September 2010, a CLABSI prevention bundle was introduced in our NICU, consisting of simulation-based standardization and education of a peripherally inserted central catheter insertion technique. Data of all VLBWI admitted to our NICU during 2010-2012 were analyzed. Diagnosis of CLABSI required a positive blood culture in the presence of a central venous catheter and clinical signs of infection. RESULTS: Five hundred twenty-six VLBWI admitted during the study period were included into the analysis. CLABSI rates decreased significantly from 13.9 in 2010 to 9.5 in 2011 and 4.7 in 2012 (P < 0.0001). This significant reduction was true for the overall population and for subgroups separated by birth weight. Distribution of blood culture pathogens revealed a constant absolute and relative decline of infections with coagulase-negative staphylococci from 2010 (n = 43/50, 86%) to 2012 (n = 12/18, 67%), as opposed by a slight increase of Staphylococcus aureus infections (n = 1/50, 2% in 2010 versus n = 2/18, 11% in 2012). CONCLUSION: Our data provide evidence of a potential effect of simulation-based training of central line placement in decreasing CLABSI rates in VLBWI and encourage its implementation into care bundles.
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Authors | Manuel Steiner, Michaela Langgartner, Francesco Cardona, Thomas Waldhör, Jens Schwindt, Nadja Haiden, Angelika Berger |
Journal | The Pediatric infectious disease journal
(Pediatr Infect Dis J)
Vol. 34
Issue 11
Pg. 1193-6
(Nov 2015)
ISSN: 1532-0987 [Electronic] United States |
PMID | 26186105
(Publication Type: Journal Article)
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Topics |
- Bacteremia
(epidemiology, prevention & control)
- Catheter-Related Infections
(epidemiology, prevention & control)
- Catheterization, Central Venous
(statistics & numerical data)
- Female
- Humans
- Infant, Newborn
- Male
- Neonatology
(education, methods, standards)
- Patient Care Bundles
(statistics & numerical data)
- Premature Birth
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