Central blood line infection reduction techniques in neonates
Keen, Kandice L.
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Neonates are infants that were born prematurely and require extra care because they are less developed than full term infants. Neonates may require central blood lines in order to transport blood or medicine to their heart. These lines are used in patients of all ages, however, neonates are the most likely to have an infected line because of their less developed immunities. Central line acquired blood stream infections (CLASBSI) are a serious problem in Neonatal Intensive Care Units (NICU) but can be prevented by increased sterility. A CLASBSI could be caused by poor line placement, dressing change technique, or line management. In order to determine the best practices of the three aspects of the neonatal central blood line, a questionnaire was sent out to all neonatologists in Region V of the American Academy of Pediatrics asking their step-by-step procedure and blood stream infections per 1,000 catheter line days- the number of infection days times 1,000 and divided by the total days that all central lines were in place. There was a low response rate of only 5% or about 150 hospitals; however it was sufficient to determine the best practices of hospitals that were surveyed. A comparison of hospitals with low blood stream infections (BSI) was performed and common practices between hospitals were considered as a factor for their low BSI. The bundling approach, a technique that requires a sterile field and a two member team to insert or change a dressing, was the practice that most hospitals agreed led to a decrease in BSI. Data analysis was also performed on the BSI for the past 10 years at Oakwood Hospital. The bundling approach was applied in February 2010 and as of December 2010 there have been no infections. The information gathered through the survey and implementations at Oakwood prove that the bundling approach is the best practice for a NICU with high BSI.