When Lori and Shayne’s baby was born at 27 weeks and only weighing 2 lbs and 10 ounces, they were scared and uncertain about what the future held for him. Emmett spent time in our Neonatal Intensive Care Unit (NICU) immediately after his birth.
In our NICU, infants who are unable to feed or who may need special medications often have a central line. This long, thin, and flexible tube is used to give nutrient-rich intravenous fluids as well as medication. Emmett was one of the babies with a central line.
Keeping the lines infection free is always our goal and part of our ongoing effort to provide the highest quality care to our youngest patients.
On September 26, 2013, the NICU at The University of Vermont Children’s Hospital (VCH) at the UVM Medical Center completed three years of clinical care free of a central line associated blood stream infection. That means 4,785 “line” days (1 baby with 1 line = 1 day) without a central line blood stream infection! To put that in context, the 2011 National Health Care Safety Network (which is part of the Centers for Disease Control and Prevention) benchmark for central line associated blood stream infection rates is between 1.3 and 2.5 per 1000 central line days (Note: This data is for infants born with birth weight <= 1 lb. 10 oz. to 3 lb. 5 oz. and cared for at a level III NICU). As our NICU saw zero central line blood stream infections, we are doing significantly better than the national benchmark.
Why is this vital? Keeping central lines infection-free is a patient safety priority both nationally and here at the UVM Medical Center. The use of the National Healthcare Safety Network provides us with a way to measure our success by benchmarking ourselves with other level III NICUs across the country. This measure is endorsed by the National Quality Forum as late bacterial central line infections are often a source of increased illness in very low birth weight infants. These infants are the most vulnerable patients in the NICU, and they likely to need a central line for the purpose of intravenous nutrition while feedings are being established.
Simply put, less (or no) central line infections means greater safety and quality for our patients. It also means that parents like Lori and Shayne can rest a little easier, knowing their baby is being taken care of in a safe environment with a focus on quality, patient safety, and infection prevention.
Who helps make this all happen? Our incredible team:
- Our bedside nurses are responsible for the quality and safety of clinical care provided in the NICU. They partner with our Neonatal Nurse Practitioners and Physician Assistants on the insertion and maintenance of central lines.
- We have an Infection Prevention Advocacy team that works on a regular basis to identify and institute infection prevention initiatives in the NICU.
- We work closely with our Infection Prevention expert at the UVM Medical Center, who is responsible for monthly reporting of infection free line days in the NICU.
- We have developed an evidence-based policy and procedure that guides new staff in the correct care maintenance of central lines. It is an integral part of our process.
Together, this team of caregivers and health care experts work to monitor, maintain and continually seek new ways to improve care and keep the NICU central line infection free.
Today, Emmett is an active, smiling little boy, enjoying all life has to offer him. It’s those smiles that make every effort to keep our NICU safe our most critical task.
Charles Mercier, MD, is Director of Neonatal Intensive Care at the University of Vermont Medical Center. He is also a Professor at the Larner College of Medicine at UVM.