Evaluation and development of potentially better practices to prevent neonatal nosocomial bacteremia

Pediatrics. 2003 Apr;111(4 Pt 2):e504-18.


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.

MeSH terms

  • Bacteremia / prevention & control*
  • Benchmarking*
  • Blood Specimen Collection / standards
  • Cooperative Behavior
  • Cross Infection / prevention & control*
  • Evidence-Based Medicine
  • Hand Disinfection / standards
  • Humans
  • 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*
  • Organizational Innovation
  • Organizational Objectives
  • Program Development
  • Program Evaluation
  • Surveys and Questionnaires
  • Total Quality Management / methods
  • United States