Two NICU nurses show a peripherally inserted central catheter (PICC). Photo courtesy of MedStar Washington Hospital Center
The neonatal intensive care unit (NICU) at MedStar Washington Hospital Center reached a remarkable safety milestone on July 31 -- three years with zero central line-associated bloodstream infections (CLABSIs) in its tiniest and most vulnerable babies. While three years CLABSI-free is extraordinary for any intensive care unit, what makes this accomplishment so remarkable is that these babies “are so small and fragile it makes it easier for infection to spread,” says Zacharia Cherian, MD, chairman of neonatology at MedStar Washington Hospital Center. “In addition, their immune systems are still immature, so fighting off infection is much more difficult than for a healthy baby.”
The NICU team at the Hospital Center spent several years perfecting a sophisticated process for inserting a PICC line (peripherally inserted central catheter) into the tiny patients. These lines are used for continuous infusion of nutrition and medication, and the long-term placement of PICC lines can create opportunities for infections.
A dedicated team of specially trained nurses handles all PICC line insertions in the NICU, and all nurses on the unit are trained in the special dressing changes and cleaning process for neonates with a PICC line. Special precautions are taken when placing the line or changing the dressing. One nurse performs the procedure, while the other monitors every step, making certain all sterile processes are followed.
“This is a team effort. Everyone here is involved in keeping the environment clean and keeping our littlest patients free from infection,” says Nuncia Dimagnaong, RN, one of the PICC line nurses in the NICU. “It takes all of us.”
“We have a very focused team, says Jacquelyn Bell-Benton, BSN, MSNc, IBCLC, the hospital director of the NICU. “At one point we almost reached two years, but then we had one infection. So, we reevaluated our processes, and aimed for one year, then two years and now three years without a single infection. I am so proud of our entire team.”
MedStar Washington Hospital Center’s NICU is a 20-bed, Level IIIa neonatology unit that treats approximately 850 patients per year.
Source: MedStar Washington Hospital Center