Implementation of a central line infection prevention bundle in neonates

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This central line infection bundle was effective in reducing CVC use, dwell time, and central line-associated bloodstream infections” McMullan and Gordon (2016).

Abstract:

OBJECTIVE: To compare central line use and central line-associated bloodstream infection in newborn infants before and after the introduction of a central line infection prevention bundle in order to determine the effectiveness of the bundle and to identify areas for further improvement.

DESIGN: Retrospective cohort analysis of prospectively collected data.

SETTING: Level 5 neonatal intensive care unit in Sydney, Australia.

PATIENTS: Newborn infants admitted to the Royal Prince Alfred Hospital Neonatal Intensive Care Unit who had a central venous catheter (CVC) inserted. METHODS Data regarding clinical characteristics, CVC use, and infection were collected before and after the introduction of a bundle of interventions. The bundles encompassed (1) insertion of CVC, (2) maintenance of CVC, (3) an education program, and (4) ongoing surveillance and feedback.

RESULTS: Baseline and intervention groups were comparable in clinical characteristics. The number of CVCs inserted was reduced in the intervention group (central line utilization rate, 0.16 vs 0.2, P<.0001). Overall CVC dwell time was reduced, resulting from significant reduction in peripherally inserted CVC dwell time (6 days [95% CI, 5.0-11.8 days] vs 7.3 days [4.0-10.4 days], P=.0004). Central line-associated bloodstream infections were significantly reduced, predominantly secondary to decreased peripherally inserted CVC-related bloodstream infections (1.2/1,000 central line-days vs 11.5/1,000 central line-days, P<.0001).

CONCLUSION: This central line infection bundle was effective in reducing CVC use, dwell time, and central line-associated bloodstream infections.

Reference:

McMullan, R. and Gordon, A. (2016) Impact of a Central Line Infection Prevention Bundle in Newborn Infants. Infection Control and Hospital Epidemiology. June 13th. [Epub ahead of print].

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