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Development of a statewide collaborative to decrease NICU central line-associated bloodstream infections

Journal of Perinatology volume 29, pages 591–599 (2009)Cite this article

Abstract

Objective:

To characterize hospital-acquired bloodstream infection rates among New York State's 19 regional referral NICUs (at regional perinatal centers; RPCs) and develop strategies to promote best practices to reduce central line-associated bloodstream infections (CLABSIs).

Study Design:

During 2006 and 2007, RPC NICUs reported bloodstream infections, patient-days and central line-days to the Department of Health, and shared their results. Aiming to improve, participants created a central line-care bundle based on visiting a potentially best performing NICU and reviewing the literature.

Result:

All 19 RPCs participated in this quality initiative, contributing 218 096 patient-days and 56 911 central line-days of observation. Individual RPC nosocomial sepsis infection (NI) rates ranged from 1.0 to 5.8 NIs per 1000 patient-days (2006), and CLABSI rates ranged from 2.6 to 15.1 CLABSIs per 1000 central line-days (2007). A six-fold rate variation among RPC NICUs was observed. Participants unanimously approved a level-1 evidence-based central line-care bundle.

Conclusion:

Individual RPC rates and consequent morbidity and resource use attributable to these infections were substantial and varied greatly. No center was without infections. It is hoped that the cooperation and accountability exhibited by the RPCs will result in a major network for characterizing performance and improving outcomes.

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Author information

Authors and Affiliations

  1. Department of Pediatrics/Newborn Medicine, Weill Cornell Medical College, Weill Cornell Medical Center, New York, NY, USA

    J Schulman

  2. Deparment of Public Health/Outcomes and Effectiveness, Weill Cornell Medical College, Weill Cornell Medical Center, New York, NY, USA

    J Schulman

  3. New York Presbyterian Hospital, Weill Cornell Medical Center, New York, NY, USA

    J Schulman

  4. New York State Department of Health, Bureau of Healthcare-Associated Infections, Albany, NY, USA

    R L Stricof

  5. Division of Neonatology, Department of Pediatrics, University of Rochester School of Medicine, Rochester, NY, USA

    T P Stevens

  6. Department of Pediatrics, Mt. Sinai School of Medicine, New York, NY, USA

    I R Holzman

  7. Department of Obstetrics, Gynecology and Reproductive Science, Mt. Sinai School of Medicine, New York, NY, USA

    I R Holzman

  8. New York State Department of Health, Bureau of Women's Health, Albany, NY, USA

    E P Shields

  9. Department of Pediatrics, Section of Neonatology, Albert Einstein College of Medicine, Bronx, NY, USA

    R M Angert & S M Nafday

  10. Division of Neonatology, Department of Pediatrics, New York University School of Medicine, New York, NY, USA

    R S Wasserman-Hoff

  11. Division of Infectious Diseases, Department of Pediatrics, Columbia University College of Physicians and Surgeons, New York, NY, USA

    L Saiman

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for the New York State Regional Perinatal Centers and the New York State Department of Health

Corresponding author

Correspondence to J Schulman.

Additional information

Supplementary Information accompanies the paper on the Journal of Perinatology website (http://www.nature.com/jp)

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Appendix

Appendix

Members of the NYS RPC NICU Network include: Albany Medical Center—Michael Horgan MD; Susan A Furdon MS, RNC, NNP—BC; Lynn Spilman MS, RNC, NNP—BC; Rebecca O’Donnell, MT (ASCP) CIC; Bellevue Hospital Center—Randi Wasserman, MD; Yang Kim MD; Zina Jones, RN, MS; Karen D Hendricks-Munoz MD MPH; Crouse Hospital—Michelle Bode, MD, MPH; Steven J Gross, MD; Pam Parker, RN; Jacobi Medical Center—Elena V Wachtel, MD; Margaret Moylan, RN; Long Island Jewish Medical Center—Christine Grippi RN; Robert Koppel MD; Maimonides Medical Center—Alok Bhutada MD; Shantanu Rastogi MD; Montefiore Medical Center—Suhas M Nafday MD; Robert Angert MD; Adebisi Adeyeye RN; Deborah Campbell MD; Mount Sinai Hospital—Ian R Holzman, MD; Kathleen Gibbs MD; Grace Marin RN; Mitch Reyes BS; New York University at Tisch Hospital—Martha C Caprio MD RPC; Joan Cutrone, MA, RN, CPN, LNC; Karen D Hendricks-Munoz, MD, MPH; Steven Bock BSN RN CIC; Michelle DeSomma, MSN, NNP; New York-Presbyterian/Columbia University Medical Center—Lisa Saiman, MD, MPH; David Bateman, MD; Jennifer Duchon, MD; Diane Carp, RN, MSN; Philip Graham, MD, MSc; New York-Presbyterian/Weill Cornell Medical Center—Joseph Schulman, MD, MS; Jeffrey M Perlman MB, ChB; Barbara G Ross RN BSN CIC; North Shore University Hospital—Richard J Schanler, MD; Nancy Pupke, RN; Richmond University Medical Center—Anthony Barone, MD; Strong Memorial Hospital—Timothy P Stevens, MD, MPH; Hyacinth Hoey RN; University Hospital of Brooklyn—Gloria B Valencia, MD; Nadine E Lahage, MD; University Hospital at Stony Brook—Manoj Biniwale MD; Adriann Combs RNC; Westchester Medical Center—Boriana Parvez, MD; Heather Brumberg, MD, MPH; Barbara Clones, RN, MPH, CIC; Clare Nugent, R.N.C BSN; Winthrop University Hospital—Robert Angert, MD; Teofilita Isaacson, MD; Jennifer Park, BA; Women's and Children's Hospital of Buffalo—Vasanth H Kumar, MD; Rita M Ryan, MD.

Members of the NYSDOH Bureau of Women's Health NICU Module management team include: Barbara Brustman, EdD; Rudy Lewis, MS; Eileen Shields, BA; Joann Susser, RN, BHI; Kenyatta Hills.

Members of the NYSDOH Office of Hospital-Acquired Infection: Rachel Stricoff MPH CIC.

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Schulman, J., Stricof, R., Stevens, T. et al. Development of a statewide collaborative to decrease NICU central line-associated bloodstream infections. J Perinatol 29, 591–599 (2009). https://doi.org/10.1038/jp.2009.18

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