Children's Hospital Association: Nationwide SLUG Bug Collaborative is Reducing NICU Infections

By Children's Hospital Association

Preventing central line-associated bloodstream infections (CLABSIs) is a top priority for children's hospitals—and for good reason. According to the National Center for Biotechnology Information, CLABSIs are the leading type of device-associated infections among patients in neonatal intensive care units (NICUs). Newly published research shows some promising gains hospitals are making in CLABSI prevention.

A quality improvement initiative conducted by the Standardizing Line care Under Guideline recommendations (SLUG Bug) collaborative—a partnership of more than a dozen children's hospitals aimed at reducing preventable bloodstream infections in neonatal patients—has shown substantial declines in CLABSIs. Notably, hospitals that transitioned to a sterile tubing change (TC) technique in which sterile gloves and a mask were used with a sterile barrier under the central venous catheter, reported a 64 percent decrease in CLABSI rates.

"One of the exciting points is that these participating centers already had low infection rates," says Eugenia Pallotto, M.D., M.S.C.E, the medical director of the NICU at Children's Mercy Kansas City and a co-author of the study published in Pediatrics. "But by continuing to work on this together, they were able to achieve even lower rates."

The Children's Hospitals Neonatal Consortium formed the SLUG Bug collaborative in 2011 with 17 NICUs participating. The collaborative examined a number of CLABSI prevention methods, and during the initial one-year research period experienced a drop in CLABSI rates of about 20 percent. That success was sustained during the second phase of the study, in the nearly two years that followed.

The four centers that transitioned to the TC technique during this sustain phase saw CLABSI rates plummet from 1.59 CLABSIs per 1,000 line days to 0.57 CLABSIs per 1,000 line days. Impressive results, but Pallotto says there's more to improving infection rates than any one CLABSI prevention technique.

"There's not one magic bullet to lowering infections—it's the culture of infection prevention that is important," Pallotto says. "Centers have to look at all the different possibilities and highlight practices that could be additive at their site—it's a combination of a lot of things."

Read the full article via Children's Hospital Association. 

Learn more about the Neonatal Intensive Care Unit at Children's Mercy.