Background Very low birth weight (VLBW) infants with late onset sepsis have increased risk of neurodisability. Care bundles to reduce these infections in NICU are effective. The impact of care bundles on long-term neurodevelopmental outcome has not been described. We aimed to determine if implementation of a sepsis-reduction care bundle was associated with improvement in neurodevelopmental outcomes in VLBW infants.
Methods A multimodal sepsis improvement bundle was implemented in a regional NICU from July 2006. This bundle focused on hand hygiene and line care improvements. Mortality and neurological morbidity rates were compared pre- and post intervention (Jan ‘01 - Dec ‘07 vs. Jul ‘08 – Dec ‘12). Infants had neurodevelopmental assessment at 24 months corrected gestation with Bayley Scales of Infant development. Moderate cognitive disability was defined as a cognitive/language score below 2SDs, moderate motor disability as a motor score below 2SDs.
Results Birth weight, gestation and gender were similar in both cohorts. Coagulase Negative Staphylococcus septicaemia rates reduced from 7/1000 care days before implementation to 2.8/1000 in 2012. Mortality rates were similar between the groups (66/426 vs. 40/310; p = 0.3). There was no difference in moderate motor disability (17/85 vs. 3/42; p = 0.07). There was a significant reduction in moderate cognitive disability (16/86 vs. 2/44; p = 0.03) after implementation of the sepsis care bundle.
Conclusions Sepsis-reduction care bundles improve the 2-year neurodevelopmental outcome of VLBW infants. The improvement seen in cognitive function is likely to translate into significantly less long-term learning disability.