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  • Title: Evaluation and development of potentially better practices to prevent neonatal nosocomial bacteremia.
    Author: Kilbride HW, Powers R, Wirtschafter DD, Sheehan MB, Charsha DS, LaCorte M, Finer N, Goldmann DA.
    Journal: Pediatrics; 2003 Apr; 111(4 Pt 2):e504-18. PubMed ID: 12671171.
    Abstract:
    OBJECTIVE: Six neonatal intensive care units (NICUs) that are members of the Vermont Oxford National Evidence-Based Quality Improvement Collaborative for Neonatology collaborated to reduce infection rates. There were 7 centers in the original focus group, but 1 center left the collaborative after 1 year. The objective of this study was to develop strategies to decrease nosocomial infection rates in NICUs. METHODS: The process included a comprehensive literature review, internal practice analyses, benchmark studies, and development of practical experience through rapid-cycle changes, subsequent analysis, and feedback. This process led to 3 summary statements on potentially better practices in handwashing, approach to nosocomial sepsis evaluations, and central venous catheter management. RESULTS: These statements provide a basis for an evidence-based approach to lowering neonatal intensive care unit nosocomial infection rates. CONCLUSIONS: The 2-year process also led to changes in the culture and habits of the institutions involved, which should in turn have long-term effects on other aspects of quality improvement.
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