In August 2011, the Health
Research & Educational Trust (HRET), partnering with the Perinatal Quality
Collaborative of North Carolina (PQCNC), implemented a national, neonatal central
line-associated bloodstream infection (NCLABSI) reduction project in Neonatal
Intensive Care Units (NICU). This effort was a component of the AHRQ-funded
national project to reduce CLABSI, which is a significant contributor to morbidity
and mortality for infants as well as adults and to excess costs.
This NCLABSI project brought
together neonatal State-based networks
recruited and led by a neonatologist, also referred to as a State clinical
lead. These State clinical leads worked with their State hospital associations
and recruited NICUs to participate, submit CLABSI data to PQCNC for real-time
feedback, and engage unit teams to improve safety culture using the
Comprehensive Unit-Based Safety Program (CUSP). The project had two primary
aims: 1) create and support statewide CLABSI collaboratives committed to
reducing CLABSI and 2) improve safety culture.
- A total of 100
units participated representing 9 States.
- Through the course
of the study, over 17,000 central lines were placed.
- Over 127,000
maintenance notes were logged representing over 8,400 unique patients.
- CLABSI rates
decreased from 2.043 at baseline to 0.855 in August 2012, a 58 percent relative
- During the course
of the study, an estimated 131 infections were prevented which translates to an
estimated 14-41 deaths prevented and over $2.2 million in excess costs
All nine participating States in
NCLABSI have completed plans to sustain this work. Six new States have also
expressed commitment to spreading the interventions of this project to NICUs in
Moving forward, the work started
in NCLABSI will continue to gain momentum through the State neonatal quality
collaboratives and can only grow stronger with additional partnerships through
quality improvement organizations, hospital engagement networks, insurers,
family and patient groups, and other national stakeholders.
Approximately $906,000 was invested in the national NCLABSI project resulting in
infections prevented and deaths avoided. With over $2.2 million in excess costs
averted, the return on investment is over 143 percent to date.
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