Using the Expertise of a Clinical Nurse Specialist to Lead a Neonatal Peripherally Inserted Central Catheter Team to Central Line-Associated Bloodstream Infection Reduction and Cost-Efficiency Through Quality Improvement

Abstract

Objective: This quality improvement project aimed to reduce central line bacteremias (central line-associated bloodstream infections [CLABSIs]) in a neonatal ICU (NICU) to a CLABSI rate of zero using a clinical nurse specialist (CNS)-led neonatal peripherally inserted central catheter (PICC) team.

Background: The NICU at the study site was experiencing more than twice the National Healthcare Safety Network average CLABSI rate at 2.2 per 1000 line-days with an estimated cost of $2 072 806 to the organization.

Methods: In early 2009, the CNS guided the unit from on-demand PICC placement to a dedicated team of PICC certified nurses who assumed total care of PICC line insertion and maintenance. The project used a continual, rapid cycle quality improvement model to incorporate the current evidence-based practices.

Results: The CNS-led PICC team has maintained a zero CLABSI rate for 9 years with only 1 CLABSI since June 2022.

Conclusions: The adoption of a CNS-led PICC team was instrumental in achieving a zero CLABSI rate over a prolonged period.