Effect of a Dedicated Percutaneously Inserted Central Catheter Team on Neonatal Catheter-Related Bloodstream Infection
| Autor: | An N. Massaro, Robert McCarter, Lisa Williams, Billie L. Short, Joyce Doering, Linda B. Talley, Tara Taylor, Jianping He |
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| Rok vydání: | 2011 |
| Předmět: |
Catheterization
Central Venous medicine.medical_specialty Central line Neonatal intensive care unit Proportional hazards model business.industry Birth weight Infant Newborn Gestational age General Medicine Infant Low Birth Weight Lower risk Catheter Low birth weight Catheter-Related Infections Intensive Care Units Neonatal Neonatal Nursing Sepsis Pediatrics Perinatology and Child Health Emergency medicine medicine Humans medicine.symptom Intensive care medicine business |
| Zdroj: | Advances in Neonatal Care. 11:122-128 |
| ISSN: | 1536-0903 |
| DOI: | 10.1097/anc.0b013e318210d059 |
| Popis: | Purpose To evaluate whether the establishment of a dedicated percutaneously inserted central catheter (PICC) team is associated with reduced risk of catheter-related bloodstream infection (CRBSI) in the neonatal intensive care unit. Subjects Participants were extremely low-birth-weight infants admitted to a level IIIC neonatal intensive care unit. Design A before- versus after-intervention study design was implemented. Intervention group participants were admitted after April 2006 when the PICC team was established, dedicating line insertion and maintenance responsibilities to the team. Historical control group participants were managed via the previous standard of care. Methods The risk of CRBSI over time was estimated by Kaplan-Meier analyses and the effect of the PICC team on CRBSI risk was evaluated after controlling for covariables in a Cox proportional hazards model. Principal results Mean birth weight and gestational age were similar between groups. After controlling for gestational age, central line days, respiratory support days, and average daily census at time of admission in a Cox regression model, the intervention group had 49% lower risk of CRBSI in patients who had a central line in place for more than 30 days. There was no difference in rate of CRBSI between groups that had central lines of short or intermediate duration ( Conclusions Catheter-related bloodstream infection in extremely low-birth-weight infants requiring long-term central venous access was reduced by nearly half after the institution of a dedicated PICC team in the neonatal intensive care unit. Standardizing PICC line placement is important, but standardizing line maintenance is essential to improvement of CRBSI rates. |
| Databáze: | OpenAIRE |
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