GCU
Nursing Leadership and Management
December 12, 2012
Decrease CLABSI in the NICU
The purpose of this initiative is to decrease and/or eliminate central line-associated bloodstream infections (CLABSI) in the neonatal intensive care unit (NICU) at Aurora Bay Care Medical Center. Hospital acquired infections, including CLABSI, is a major cause of mortality, prolonged hospitalization, and extra costs for NICU patients (Stevens & Schulman, 2012). The goal of this initiative is to decrease CLABSI by 75% by reducing the number of days lines are in and standardizing the insertion process and line maintenance.
CLABSI is preventable and increases the risk of neurodevelopmental impairment in very low birth weight infants. It is estimated that up to 70% of hospital acquired infections are caused by CLABSI in preterm infants (Stevens & Schulman, 2012). It is also estimated that 41,000 CLABSI occur in United States hospitals every year (Centers for Disease Control and Prevention [CDC], 2012). It is easily preventable by managing the central line properly. Insertion of the central line must be done completely sterile and rigorous care needs to be done with catheter care. The catheter hub is the main culprit of infections so that needs to be a large part of the initiative (Stevens & Schulman, 2012).
The participants in this initiative include neonatologists, neonatal nurse practitioners, nurses, infection control personnel, the NICU supervisor, and the NICU manager. Together, they will form a core team of 10 people with at least one person from each level of care. The team will analyze the NICU practices and establish practice based on evidenced based practice. The team will investigate the cause of each infection and agree on changes that need to be made. They will meet every other week until the new practices have been established, at which time they can determine how often they need to meet. Each member must play
References: Centers for Disease Control and Prevention. (2012). Central line-associated bloodstream infection (CLABSI) event. Retrieved from http://www.cdc.gov/nhsn/pdfs/pscmanual/4psc_clabscurrent.pdf Horan, T. C. (2010). Central line-associated bloodstream infection (CLABSI) criteria and case studies. Retrieved from http://www.azdhs.gov/phs/oids/hai/documents/NHSN_Workshop1_CLABSI_Criteria_Studies.pdf Stevens, T. P., & Schulman, J. (2012). Evidence-based approach to preventing central line-associated blood stream infection in the NICU. Acta Paeditrica, 11-16. doi:10.1111/j.1651-2227.2011.02547.x