title: Central line bloodstream infections can be reduced in newborn infants using the modified Seldinger technique and care bundles of preventative measures.
abstract: OBJECTIVE
  There has been no evidence to show whether care bundles of preventive measures reduce central line-associated bloodstream infection (CLABSI) in peripherally inserted central catheters using the modified Seldinger technique, which requires more specific skills than the traditional technique. The aim of this study was to address that gap in our knowledge and to determine whether other variables influenced the outcome.
  
  
  METHODS
  This prospective observational study was conducted on a neonatal intensive care unit. We observed the incidence of CLABSI in 45 newborn infants with peripheral catheters before the introduction of bundles of preventative measures and 88 infants after the introduction.
  
  
  RESULTS
  Laboratory-confirmed CLABSI decreased after the introduction of the bundles, from 12.9 per 1000 days to 4.7/1000 days (p = 0.09). When we combined the rates for laboratory-confirmed CLABSI and clinical CLABSI in a survival analysis, the incidence reduced significantly after introduction of the bundles (p = 0.02). There were no other variables that affected the outcome.
  
  
  CONCLUSIONS
  Cost-effective care bundles reduced CLABSI in peripherally inserted central catheters using the modified Seldinger technique, despite the specific insertion skills that were required. The bundles of preventative measures may increase healthcare professionals' awareness of the need to care for central catheters and reduce CLABSI infections.
authors.affiliation: Department of Neonatology, Radboud University Medical Centre, Nijmegen, The Netherlands.
authors.forename: I J J
authors.initials: IJ
authors.lastname: Arnts
authors.forename: N M
authors.initials: NM
authors.lastname: Schrijvers
authors.forename: M
authors.initials: M
authors.lastname: van der Flier
authors.forename: J M M
authors.initials: JM
authors.lastname: Groenewoud
authors.forename: T
authors.initials: T
authors.lastname: Antonius
authors.forename: K D
authors.initials: KD
authors.lastname: Liem
mesh_terms: D055499:Catheter-Related Infections / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control*; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D064872:Patient Care Bundles / Q000379:methods*; D011446:Prospective Studies
keywords: Central line-associated bloodstream infection; Central venous catheters; Modified Seldinger method; Newborn infants