减少新生儿重症监护病房中心线相关血流感染(CLABSI)事件的新策略

Ingrid Camelo, Srilatha Neshangi, Amy Thompson
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引用次数: 0

摘要

背景:我们描述了2021年7月至9月在一家三级医疗保健中心实施的一项改进且易于实施的策略的组成部分,以减少新生儿重症监护病房的CLABSI事件。这些策略被添加到根据CDC指南创建的现有机构协议中。方法:在之前实施新策略的时间框架内,CDC插入相关预防措施[即手卫生、使用个人防护装备(PPE)、导管尺寸选择、标准葡萄糖酸氯己定(CHG)消毒、维护相关的Curos消毒帽和擦洗中心]是我们机构现有方案的一部分。我们在之前的基础上引入了以下关键要素:将脐静脉导管(UVC)的使用时间从14天减少到5-7天,将敷料材料从BIOPATCH改为3M Tegaderm CHG葡萄糖酸氯己定IV安全透明敷料,提高现有人工指甲政策的依从性,限制中央静脉采血。结果:通过这些额外的策略对先前的方案进行优化后,我们实现了NICU CLABSI发生率的显著降低,从2020年7月至2021年6月的12例CLABSI事件降低到2021年7月至2022年6月的3例CLABSI事件。结论:应经常修订CLABSI捆绑预防方案,以便增加改进机会以降低感染率。在现有的CLABSI包中增加简单和易于实施的关键要素干预措施对我们机构的CLABSI率产生了重要影响。披露:没有
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Novel strategies to reduce central-line–associated blood stream infection (CLABSI) events in the neonatal intensive care unit
Background: We describe the components of an improved and easy-to-implement strategy to reduce CLABSI events in the NICU implemented during July–September 2021 in a tertiary-care healthcare center. These strategies were added to an existing institutional protocol created following CDC guidelines. Methods: During the previous timeframe of the implementation of new strategies, CDC insertion-related prevention measures [ie, hand hygiene, use of personal protective equipment (PPE), catheter size selection, standard chlorhexidine gluconate (CHG) antisepsis, maintenance related Curos disinfecting caps, and scrubbing the hub] were part of an existing protocol at our institution. We introduced the following key elements along with the previous ones: decrease length of umbilical vein catheter (UVC) utilization from 14 days to 5–7 days, change of dressing materials from BIOPATCH to 3M Tegaderm CHG chlorhexidine gluconate IV securement transparent dressing, enhanced compliance of an existing artificial nail policy, and restricted blood draw from central lines. Results: After optimization of the previous protocol through these additional strategies, we achieved a significant reduction in the NICU CLABSI rates from 12 CLABSI events between July 2020 and June 2021 to only 3 CLABSI events between July 2021 and June 2022. Conclusions: Revision of CLABSI bundle prevention protocols should be performed frequently to allow improvement opportunities to be added to diminish infection rates. The addition of simple and easy-to-implement key elements interventions to the existing CLABSI bundle had an important impact on the CLABSI rate at our institution. Disclosures: None
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