Utilizing a line maintenance team to reduce central-line-associated bloodstream infections in a neonatal intensive care unit.
OBJECTIVE
To determine the association of a central-line maintenance team on the incidence of central-line-associated bloodstream infections (CLABSIs) in the neonatal intensive care unit (NICU).


METHODS
Central line maintenance in the NICU was limited to a line team starting in March 2008. CLABSI rates were determined before (December 2006 to February 2008) and after implementation of the line team ( March 2008 to August 2010) utilizing consistent National Healthcare Safety Network definitions. Rates were calculated by birth weight categories and overall. Data analysis was performed by two-proportion t test using Minitab.


RESULTS
Overall CLABSI decreased by 65% after implementation of the line team. Pre intervention, mean overall CLABSI rate was 11.6 /1000, as compared with 4.0/1000 after intervention (P<0.001). Birth-weight-specific CLABSI rates also decreased significantly. Decreased infection rates were sustained over time.


CONCLUSIONS
A line team provided for standardized, consistent central-line maintenance care leading to a significant, sustained decrease in CLABSI in a NICU.
Department of Pediatrics, University of Texas Medical School at Houston, Houston, TX, USA. Holzmann-Pazgal@uth.tmc.edu
G
G
Holzmann-Pazgal
A
A
Kubanda
K
K
Davis
A M
AM
Khan
K
K
Brumley
S E
SE
Denson
D016470:Bacteremia / Q000453:epidemiology / Q000209:etiology / Q000451:nursing / Q000517:prevention & control*; D001724:Birth Weight; D055499:Catheter-Related Infections / Q000453:epidemiology / Q000209:etiology / Q000451:nursing / Q000517:prevention & control*; D002405:Catheterization, Central Venous / Q000009:adverse effects* / Q000451:nursing*; D002408:Catheters, Indwelling / Q000382:microbiology*; D057189:Checklist; D003428:Cross Infection / Q000453:epidemiology / Q000209:etiology / Q000451:nursing / Q000517:prevention & control*; D003430:Cross-Sectional Studies; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D009746:Nursing, Team; D012307:Risk Factors; D018805:Sepsis / Q000453:epidemiology / Q000209:etiology / Q000451:nursing / Q000517:prevention & control*; D013781:Texas