Implementation of evidence-based potentially better practices to decrease nosocomial infections

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. Nosoc...

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Bibliographic Details
Published in:Pediatrics (Evanston) 2003-04, Vol.111 (4 Pt 2), p.e519-e533
Main Authors: Kilbride, Howard W, Wirtschafter, David D, Powers, Richard J, Sheehan, Michael B
Format: Article
Language:English
Subjects:
Bacteremia - epidemiology
Bacteremia - prevention & control
Benchmarking
Catheters, Indwelling - standards
Cooperative Behavior
Cross infection
Cross Infection - epidemiology
Cross Infection - prevention & control
Evidence-Based Medicine
Hand Disinfection - standards
Health aspects
Health Plan Implementation - methods
Humans
Incidence
Infant, Newborn
Infant, Premature
Intensive Care Units, Neonatal - organization & administration
Intensive Care Units, Neonatal - standards
Intensive Care, Neonatal - methods
Intensive Care, Neonatal - organization & administration
Intensive Care, Neonatal - standards
Neonatal intensive care
Nosocomial infections
Organizational Innovation
Outcome Assessment (Health Care)
Pediatrics
Prevention
Staphylococcal Infections - epidemiology
Staphylococcal Infections - prevention & control
Total Quality Management - methods
United States
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Summary: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. Nosocomial infection is a significant area for improvement in most NICUs. Six NICUs participating in the Vermont Oxford Network made clinical changes to address 3 areas of consensus: handwashing, line management, and accuracy of diagnosis. The summary statements were widely communicated. Review of the literature, internal assessments, and benchmarking visits all contributed to ideas for change. The principle outcome was the incidence of coagulase-negative staphylococcus bacteremia. There was an observed reduction from 24.6% in 1997 to 16.4% in 2000. The collaborative process for clinical quality improvement can result in effective practice changes.
ISSN:0031-4005
1098-4275