• Edward G Shepherd, Tami J Kelly, Jodi A Vinsel, Dennis J Cunningham, Erin Keels, Wendi Beauseau, and Richard E McClead.
• Department of Pediatrics, The Ohio State University, Columbus, OH; Nationwide Children's Hospital, Columbus, OH.
• J. Pediatr. 2015 Jul 1;167(1):41-6.e1-3.

ObjectiveTo describe a quality improvement (QI) initiative that was associated with a dramatic reduction in neonatal central-line associated bloodstream infection (CLABSI) rate in a diverse group of 8 intensive care nurseries (Neonatal Services).Study DesignA quasi-experimental time series QI initiative using the model for improvement and evidenced-based interventions.ResultsThe aggregate CLABSI rate for Nationwide Children's Hospital-associated Neonatal Services decreased from 6.0 CLABSI per 1000 catheter days to 1.43 CLABSI per 1000 catheter days in less than 2 years and has remained in control at 0.68 per 1000 catheter days for over 5 years. Each of 8 nurseries has had a 1 year or more CLABSI-free period, including the neonatal intensive care unit with the largest patient volume, acuity, and central line usage. Aggregate Neonatal Services has experienced 3 CLABSI-free quarters since 2007. Key success factors included: (1) engagement of senior executive leadership; (2) bedside "huddles" among clinical and epidemiology staffs conducted within 72 hours after a positive blood culture; (3) implementation of chlorhexidine antisepsis and the use of chlorhexidine-impregnated catheter site discs; and (4) and establishment of a dedicated team for percutaneously inserted central catheter insertion to serve units in which central lines are placed less frequently.ConclusionsUsing the model for improvement and evidenced-based interventions, this QI project has been associated with reduction in the CLABSI rate by 89%, and over 430 CLABSIs likely have been avoided.Copyright © 2015 Elsevier Inc. All rights reserved.

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