title: Effect of a dedicated percutaneously inserted central catheter team on neonatal catheter-related bloodstream infection.
abstract: OBJECTIVE
  To evaluate whether the establishment of a dedicated percutaneously inserted central catheter (PICC) team is associated with reduced risk of catheter-related bloodstream infection (CRBSI) in the neonatal intensive care unit.
  
  
  METHODS
  Participants were extremely low-birth-weight infants admitted to a level IIIC neonatal intensive care unit.
  
  
  METHODS
  A before- versus after-intervention study design was implemented. Intervention group participants were admitted after April 2006 when the PICC team was established, dedicating line insertion and maintenance responsibilities to the team. Historical control group participants were managed via the previous standard of care.
  
  
  METHODS
  The risk of CRBSI over time was estimated by Kaplan-Meier analyses and the effect of the PICC team on CRBSI risk was evaluated after controlling for covariables in a Cox proportional hazards model.
  
  
  RESULTS
  Mean birth weight and gestational age were similar between groups. After controlling for gestational age, central line days, respiratory support days, and average daily census at time of admission in a Cox regression model, the intervention group had 49% lower risk of CRBSI in patients who had a central line in place for more than 30 days. There was no difference in rate of CRBSI between groups that had central lines of short or intermediate duration (<30 days).
  
  
  CONCLUSIONS
  Catheter-related bloodstream infection in extremely low-birth-weight infants requiring long-term central venous access was reduced by nearly half after the institution of a dedicated PICC team in the neonatal intensive care unit. Standardizing PICC line placement is important, but standardizing line maintenance is essential to improvement of CRBSI rates.
authors: Departments of Nursing, Children's National Medical Center, Washington, District of Columbia 20010, USA. ttaylor@cnmc.org
authors: Tara
authors: T
authors: Taylor
authors: An
authors: A
authors: Massaro
authors: Lisa
authors: L
authors: Williams
authors: Joyce
authors: J
authors: Doering
authors: Robert
authors: R
authors: McCarter
authors: Jianping
authors: J
authors: He
authors: Linda
authors: L
authors: Talley
authors: Billie
authors: B
authors: Short
mesh_terms: D055499:Catheter-Related Infections / Q000517:prevention & control*; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal / Q000592:standards*; D017283:Neonatal Nursing / Q000592:standards; D018805:Sepsis / Q000517:prevention & control*