کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
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6220257 | 1607441 | 2015 | 9 صفحه PDF | دانلود رایگان |
ObjectiveTo describe a quality improvement (QI) initiative that was associated with a dramatic reduction in neonatal central-line associated bloodstream infection (CLABSI) rate in a diverse group of 8 intensive care nurseries (Neonatal Services).Study designA quasi-experimental time series QI initiative using the model for improvement and evidenced-based interventions.ResultsThe aggregate CLABSI rate for Nationwide Children's Hospital-associated Neonatal Services decreased from 6.0 CLABSI per 1000 catheter days to 1.43 CLABSI per 1000 catheter days in less than 2Â years and has remained in control at 0.68 per 1000 catheter days for over 5Â years. Each of 8 nurseries has had a 1Â year or more CLABSI-free period, including the neonatal intensive care unit with the largest patient volume, acuity, and central line usage. Aggregate Neonatal Services has experienced 3 CLABSI-free quarters since 2007. Key success factors included: (1) engagement of senior executive leadership; (2) bedside “huddles” among clinical and epidemiology staffs conducted within 72Â hours after a positive blood culture; (3) implementation of chlorhexidine antisepsis and the use of chlorhexidine-impregnated catheter site discs; and (4) and establishment of a dedicated team for percutaneously inserted central catheter insertion to serve units in which central lines are placed less frequently.ConclusionsUsing the model for improvement and evidenced-based interventions, this QI project has been associated with reduction in the CLABSI rate by 89%, and over 430 CLABSIs likely have been avoided.
Journal: The Journal of Pediatrics - Volume 167, Issue 1, July 2015, Pages 41-46.e3