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1759 Reduction in Central Line Associated Bloodstream Infections by Introducing a Quality Improvement Pathway ‘Clean Line’
  1. OJ Kleinlugtenbeld,
  2. HLM van Straaten,
  3. MI van den Bos,
  4. MAC Hemels,
  5. EJ d’Haens
  1. Neonatology, Isala Clinics, Zwolle, The Netherlands

Abstract

Background Central lines (umbilical arterial/venous catheter, central venous catheter) are commonly used for NICU patients.

The most common complication is the Central Line Associated nosocomial Bloodstream Infection (CLABSI).

Reducing CLABSIs improves short and long term outcome for premature newborn.

Implementing bundles of care may reduce CLABSIs.

Aim Does implementation of “bundles of care” reduce CLABSIs/1000 catheter days?

Methods In 2010 a task group ‘Clean Line’ (neonatologist, Nurse Practitioner, hygienist, NICU nurse and ward manager) defined five bundles of care:

  1. optimal insertionconditions,

  2. handhygiene,

  3. daily line care,

  4. daily review of line necessity and

  5. daily inspection of insertion site.

For each carebundle the procedures were evaluated on an evidence-based manner and changed where needed. Video demonstrating best practice, multidisciplinary education and short checklists for monitoring compliance were used for implementation.

In 2011 the pathway started with the first two bundles of care. Data of CLABSIs and catheter days were compared with a historical cohort (2007). CLABSI is defined as clinical sepsis >72 hours after birth with a positive blood culture without other focus.

Abstract 1759 Table 1

Conclusion A NICU quality improvement pathway with implementation of bundles of care can reduce the number of catheter-related infections/1000 catheter days.

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