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

Pediatrics. 2003 Apr;111(4 Pt 2):e519-33.


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. Nosocomial infection is a significant area for improvement in most NICUs.

Methods: 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.

Results: 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.

Conclusions: The collaborative process for clinical quality improvement can result in effective practice changes.

MeSH terms

  • Bacteremia / epidemiology
  • Bacteremia / prevention & control*
  • Benchmarking*
  • Catheters, Indwelling / standards
  • Cooperative Behavior
  • Cross Infection / epidemiology
  • Cross Infection / prevention & control*
  • Evidence-Based Medicine
  • Hand Disinfection / standards
  • 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*
  • Organizational Innovation
  • Outcome Assessment, Health Care
  • Staphylococcal Infections / epidemiology
  • Staphylococcal Infections / prevention & control
  • Total Quality Management / methods
  • United States