Checklists Can Prevent Fatal Infections in SC Newborns

Blood infections in newborn babies in South Carolina were reduced by up to 58 percent in hospitals where intensive care workers used safety checklists, a new study shows.

The checklists covered the steps to be taken when blood catheters were inserted in an infant’s vein or artery. If the procedure is not done properly, the infant risks getting a bloodstream infection that can result in serious accidental injury or death.

Simply by using the checklists – and communicating more effectively with each other – workers in neonatal ICUs were able to prevent an estimated 131 newborn infections and 41 deaths.

South Carolina was one of nine states – and 100 hospital neonatal intensive care units (NICUs) – that participated in the study, which was conducted by the Agency for Healthcare Research and Quality.

Following is from the AHRQ news release:
CLABSIs are healthcare-associated infections (HAIs) that cause serious illness and death in infants as well as adults. A central line is a tube (catheter) that goes into a patient’s vein or artery and ends in the central bloodstream. In newborns, especially premature infants, central lines can remain in place for weeks or months to provide nutrients and medications as babies become able to function on their own.

Health care teams in the project states, caring for a total of 8,400 newborns, used AHRQ’s Comprehensive Unit-based Safety Program (CUSP) to improve safety culture and consistently implement catheter insertion and maintenance guidelines. CUSP is customizable and helps hospitals understand and apply the science of safety and take actions to improve teamwork and communications.

When the project began, participating NICUs had an overall infection rate of 2.043 per 1,000 central line days. At the end of the project, that rate was reduced to 0.855 per 1,000 central line days, a relative reduction of 58 percent.

“The CUSP framework brings together safety culture, teamwork and best practices–a combination that is clearly working to keep these vulnerable babies safer,” says AHRQ Director Carolyn M. Clancy, M.D. “These remarkable results show us that, with the right tools and dedicated clinicians, hospital units can rapidly make care safer..

The nine-state project in NICUs is part of a larger AHRQ-funded effort to implement CUSP to prevent CLABSIs nationwide.

The 11-month study was based on safety guidelines developed by the Centers for Disease Control and Prevention. In addition to South Carolina, participating states were Colorado, Florida, Hawaii, Massachusetts, Michigan, New Jersey, North Carolina and Wisconsin.

You can view the final report here. Get more information on AHRQ’s efforts to improve neonatal care here and here.

Source: AHRQ http://www.ahrq.gov/news/press/pr2013/nclabsipr.htm