Central line bloodstream infections can be reduced in newborn infants using the modified Seldinger technique and care bundles of preventative measures

Abstract

Cost-effective care bundles reduced CLABSI in peripherally inserted central catheters using the modified Seldinger technique, despite the specific insertion skills that were required. The bundles of preventative measures may increase healthcare professionals' awareness of the need to care for central catheters and reduce CLABSI infections.

Bloodstream Infection Incidence of Different Central Venous Catheters in Neonates: A Descriptive Cohort Study

“…Despite excluding the preterm and primarily smaller infants with the highest risk for infection, the CLABSI incidence in our cohort was high compared to the reported incidence in infants >2,500 g. Low gestational age and hygiene are important factors influencing the incidence of CLABSI. Studies have shown that education of medical staff about hygiene, new disinfectant methods, and the use of specific care bundles for catheter placement can reduce the incidence of CLABSI (15, 17, 21, 22). During the last years, we introduced several evidence-based strategies to reduce the incidence of CLABSI in our NICU.…”

“…We did not demonstrate a significant difference in CLABSI risk between three catheter types in the NICU. Several studies conducted on how to decrease the incidence of CLABSI have recently shown that proper education of medical staff, the use of specific care bundles and standardization of protocols can prevent CLABSI (15, 21, 22, 33). More extensive follow-up studies are needed to determine the actual incidences of CLABSI in neonates of all gestational ages, which factors genuinely affect the risk of CLABSI and what methods are the most effective for preventing these events.…”

Bundle para manuseio do cateter central de inserção periférica em neonatos

“…Such care provides significant reductions in the CLABSI, however, there is no consensus on the use of 70% alcohol and the alcoholic antiseptic solution of chlorhexidine gluconate in neonatology. (23,25,26) In this study, the use of 70% alcohol had a better adhesion by the judges (CVI = 1).…”

“…It was identified a lack of studies about this theme related to this specific population, being this, one of the limiting factors of the study. (9,(24)(25)(26)(27) Adherence to the use of bundle has shown significant results in reducing CLABSI in NICU, linked to permanent education practices. (9,26) A meta-analysis aimed at evaluating the efficacy of bundles of CLABSI prevention in neonatal, pediatric and adult Intensive Care Unit, identified that this strategy implementation in different countries presents positive results in costs reduction.…”

“…(9,24) Regarding the exchange of the stopcocks and connectors, item 4 of the Bundle, it was followed the guidelines of The Brazilian Health Regulatory Agency (ANVISA -Agência Nacional de Vigilância Sanitária), with the recommendation to perform it immediately when there are clots present or after collection of blood or administration of blood products, and with interval less than 96 hours if they remain unchanged; confirming the recommendations of other studies. (16,25,27) Item 5 includes the performance of the permeability test of the access before and after the use, to minimize the return of blood to the lumen of the Perform hand hygiene for 40 to 60 seconds, before and after handling the PICC with antiseptic solution of chlorhexidine gluconate and/or 70% alcohol gel; use procedure gloves and take off adornments.…”