Leading the way in reducing neonatal bloodstream infections

Akron Children’s efforts to reduce bloodstream infections, including central line-associated bloodstream infections (CLA-BSI), may have garnered a national award in 2011, but the real impact is in the lives of the critically ill children who come to us for care.

Akron Children's Neonatal Intensive Care Unit (NICU) was recently recognized nationally for having a CLA-BSI rate that is more than 15 percent below the international NICU average for the most at-risk babies treated.

The Sustained Improvement Award for Achievements in Eliminating Central Line-Associated Bloodstream Infections was presented at the American Association of Critical Care Nurses’ 2011 National Teaching Institute & Critical Care Exposition. It was sponsored by the U.S. Department of Health and Human Services, Office of the Assistant Secretary for Health, Office of Healthcare Quality and the Critical Care Societies Collaborative.

“We will not stop working on this until our rate is zero,” said Judy Ohlinger, MSN, RNC, improvement and research coordinator of the NICU.

click on image to enlarge

click on image to enlarge

Newly born infants in general, and premature infants in particular, are more susceptible to bloodstream infections because of immature immune systems, poor skin integrity, repeated invasive procedures, exposure to numerous caregivers and being in an environment conducive to abnormal microbial colonization.

It’s estimated that each neonatal bloodstream infection costs about $35,000 and adds about two weeks to a baby’s hospital stay.

In 2007, the NICU staff identified bloodstream infection reduction as a focus area for improvement. At that time, the BSI rate for all infants in Children’s NICU was 10 percent. For infants 22-29 weeks gestation at birth, the most at-risk group, the rate was 31 percent.

By 2009, Children’s NICU infection rate for all infants was down to 2.6 percent compared to a 5.2 percent national average, and for the most at-risk babies, 7.8 percent compared to a 23.8 percent national average.

Though the data is not yet finalized for 2010, Children’s NICU infection rate for all infants was 3.4 percent compared to a 4.7 percent international average, and 11.2 percent for the most at-risk babies compared to a 22.6 percent international average, demonstrating that the improvement has been sustained over time.

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Reducing neonatal bloodstream infections
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