Using the Expertise of a Clinical Nurse Specialist to Lead a Neonatal Peripherally Inserted Central Catheter Team to Central Line-Associated Bloodstream Infection Reduction and Cost-Efficiency Through Quality Improvement.
Susan Bedwell, Myka Oberlechner, Ulana Pogribna, Kris Sekar
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Abstract
Objective: This quality improvement project aimed to reduce central line bacteremias (central line-associated bloodstream infections [CLABSIs]) in a neonatal ICU (NICU) to a CLABSI rate of zero using a clinical nurse specialist (CNS)-led neonatal peripherally inserted central catheter (PICC) team.
Background: The NICU at the study site was experiencing more than twice the National Healthcare Safety Network average CLABSI rate at 2.2 per 1000 line-days with an estimated cost of $2 072 806 to the organization.
Methods: In early 2009, the CNS guided the unit from on-demand PICC placement to a dedicated team of PICC certified nurses who assumed total care of PICC line insertion and maintenance. The project used a continual, rapid cycle quality improvement model to incorporate the current evidence-based practices.
Results: The CNS-led PICC team has maintained a zero CLABSI rate for 9 years with only 1 CLABSI since June 2022.
Conclusions: The adoption of a CNS-led PICC team was instrumental in achieving a zero CLABSI rate over a prolonged period.
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