Pediatrics

30/30 Education Session - 30 minutes

2308 - CLABSI Prevention: Baby Bundle in an 80-Bed NICU

Thursday, June 15
2:15 PM - 2:45 PM
Location: Oregon Convention Center, A 105-106

Women & Infants Hospital houses an 80-bed neonatal intensive care unit (NICU), one of the largest single-room NICUs in the country. Over the past 6 years, through a collaborative effort of NICU attending physicians, neonatology Fellows, the PICC team, front-line nurses, and support staff, the NICU has reduced the central line-associated bloodstream infection (CLABSI) standardized infection ratio (SIR) from 1.2 to 0.209 (p = 0.0292), a statistically significant improvement that has been sustained for 3 years. In terms of patient harm, the raw number of infants infected fell from 12 to 2 per year, with a notable stretch of 54 weeks with zero CLABSI. The journey to zero took several years, but the methodical and collaborative approach was worth the sustained results. Infection prevention bundles and policies that work in the "adult" acute care world may not be suited for neonates. Infants are not tiny adults; consideration must be given to safety and appropriateness of infection prevention measures in the NICU. A knowledgeable and inclusive team of physicians, nurses, laboratorians, and nutritionists is required to select components of the prevention bundle.
CLABSI prevention is critical to patient safety, especially in vulnerable premature infants. Using the prior rate of bloodstream infections in the NICU, without our interventions, an estimated 42 babies would have experienced CLABSI between January 2013 and June 2016. Instead, there were 10 infections during this timeframe: An estimated 32 infections were prevented. Using a mortality range of 12 to 25 percent for neonatal CLABSI, between four and eight lives were saved. Excess healthcare cost for each NICU CLABSI is estimated to be $16,800, for a total cost avoidance of $537,600.00 over the 3.5-year period. Additional dollars were earned back through Centers for Medicare & Medicaid Services (CMS) value-based purchasing, and loss of hospital-acquired condition dollars was minimized. The target audience includes novice to expert infection preventionists, staff nurses, neonatologists, nursing and medical students, and healthcare administrators.

Learning Objectives:


Robin Neale

Director Infection Prevention
Care New England Health System
East Greenwich, Rhode Island

Robin Neale is the Director of Infection Prevention for Care New England Health System. Robin began her career as a medical technologist working in microbiology and advanced to laboratory manager, compliance officer, and infection preventionist. She became Director of Infection Prevention at Women & Infants Hospital in 2010, and currently serves as System Director for Care New England. Robin co chairs the Sepsis Task Force for the 80-bed NICU at Women & Infants. In collaboration with the PICC team, Robin helped implement a CLABSI prevention baby bundle responsible for significant improvement in CLABSI rates. Robin worked with other concerned healthcare providers and state legislative advocates to change HIV testing regulations in Rhode Island. Under Robin’s leadership, Women & Infants implemented opt-out prenatal HIV testing and mandatory flu vaccination for healthcare workers was implemented across Care New England. Robin is a long-standing APIC member, has acheived Fellow designation, and maintains CIC certification.

Presentation(s):

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Pat Jackson

Director, Infection Prevention and Control
Children's Health, Dallas

Pat Jackson is the Director of Infection Prevention and Control at Children’s Health in Dallas Texas. She has been an Infection Preventionist for 23 years and has been certified by the Certification Board of Infection Control and Epidemiology since 1996. Jackson was an inaugural member of APIC's Fellow class. Pat has served in various positions in both the local APIC DFW chapter as well as national APIC in which she currently serves as a member of the Board of Directors. Pat was chosen as a Covidien Hero of Infection Prevention in 2008, a DFW Great 100 nurse in 2014 and a D magazine Excellence in Nursing award winner in 2016. In 2005 her team was responsible for the recall of an FDA approved device that was contaminated with Burkholderia cepacia. Pat received her Bachelor of Science Nursing Degree from Baylor University.

Presentation(s):

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