6463 Reducing central line-associated blood stream infections in a tertiary neonatal unit: a quality improvement project

Objectives Central line-associated bloodstream infections (CLABSI) are the most common health-care-associated infections in neonatal intensive care units.¹ CLABSI are primary bloodstream infections in patients that had a central line in place within 48 hours before the development of the infection.² CLABSI rates are calculated as follows: number of line infections/number of central line days x 1000. In 2021, analysis of data from 2020 revealed our unit CLABSI rate was >7/1000 central line days. Multiple interventions were then implemented with the aim of reducing CLABSI rates to <5/1000 central line days within two years. Methods Over a two-year period, multiple interventions were implemented in a phased manner with the aim of reducing CLABSI rates (table 1). To determine the effectiveness of those interventions, CLABSI rates were calculated for two six-month periods pre and post implementation (data from 2020 and 2023 respectively). For each positive blood culture reported within these time frames, medical records were reviewed to determine if a central line was in situ within the 48 hours prior to the collection of the culture. The number of central line days for each six-month period was obtained from a neonatal database. Results Pre intervention, 7 infants with positive blood cultures had a central line in situ during the 48 hours prior to the culture collection. The number of central line days during this period was 631, providing a CLABSI rate of 11.09. Post intervention, one infant had a central line in the 48 hours prior to positive culture collection. The number of central line days was 740, providing a CLABSI rate of 1.35 (figure 1). Conclusion Following the implementation of multiple interventions, a significant reduction in the CLABSI rate occurred on our neonatal unit. References Ista, E, van der Hoven, B, Kornelisse, RF, van der Starre, C, Vos, MC, Boersma, E & Helder, OK. The Lancet: Infectious Diseases 2016. Centre for Health and Data Analysis. Rhode Island Department of Health 2012.