Table 2.
Compliance with hand hygiene and central line-associated bloodstream infection prevention bundles in the neonatal and pediatric intensive care units from 2016 through 2022
| Compliance | |||||||||
|---|---|---|---|---|---|---|---|---|---|
| Hygiene bundle | |||||||||
| Year | Hand hygiene | Maintenance bundle | Insertion bundle | Daily Bath | Mouth care | Clean high-touch surfaces | Daily linen change | Overall | Line days |
| NICU | |||||||||
| 2016 | NA | 92.8% (278) | 97.9% (95) | NA | NA | NA | NA | NA | NA |
| 2017 | NA | 96.2% (159) | 96.9% (131) | 87.8% | 91.7% | 98.3% | 84.7% | 70.4% | 5821 |
| 2018 | 100.0% (219) | 100.0% (6) | 98.6% (148) | 89.0% | 90.5% | 92.6% | 85.7% | 67.7% | 4948 |
| 2019 | 93.9% (932) | 99.3% (304) | 98.0% (152) | 91.6% | 91.7% | 90.8% | 86.7% | 69.2% | 4522 |
| 2020 | 97.4% (1857) | 98.0% (354) | 94.9% (156) | 93.8% | 93.2% | 92.2% | 88.1% | 73.9% | 5384 |
| 2021 | 99.5% (1326) | 98.1% (258) | 98.7% (156) | 92.9% | 95.9% | 93.3% | 90.7% | 77.8% | 5208 |
| 2022 | 98.8% (1467) | 96.7% (180) | 95.2% (165) | 90.0% | 97.0% | 96.0% | 90.4% | 78.5% | 5061 |
| PICU | |||||||||
| 2016 | NA | 93.1% (276) | 97.6% (418) | NA | NA | NA | NA | NA | NA |
| 2017 | NA | 93.2% (206) | 98.9% (348) | 93.4% | 86.6% | 97.3% | 86.7% | 71.9% | 3903 |
| 2018 | 85.9% (333) | 95.6% (205) | 98.7% (397) | 95.2% | 81.6% | 88.9% | 86.9% | 64.4% | 3336 |
| 2019 | 88.6% (1224) | 99.2% (130) | 98.8% (425) | 95.2% | 77.1% | 88.1% | 88.2% | 63.0% | 4052 |
| 2020 | 94.8% (842) | 97.6% (127) | 98.6% (348) | 94.6% | 72.2% | 89.3% | 88.0% | 60.4% | 3231 |
| 2021 | 92.9% (860) | 98.0% (100) | 97.4% (385) | 94.6% | 73.5% | 90.9% | 87.2% | 59.5% | 3940 |
| 2022 | 91.4% (592) | 91.7% (72) | 94.4% (356) | 91.7% | 73.1% | 92.2% | 85.3% | 57.9% | 3728 |
CLABSI is central line-associated bloodstream infection. NA is not applicable. CHG is chlorhexidine gluconate. NICU is neonatal intensive care unit. PICU is pediatric intensive care unit.
For hand hygiene, maintenance bundle and insertion bundle, data are shown as the annual percent compliance (total number of observations). For the hygiene bundle components, data are shown as percent compliance based on the annual line days.
Healthcare worker hand hygiene was monitored by covert observations made by healthcare worker volunteers during routine care and recorded electronically beginning in 2018.
The CLABSI insertion and maintenance bundles were implemented in 2005.
The maintenance bundle included: hand hygiene and donning gloves prior to accessing the line, scrubbing the line access point prior to access, assessing and documenting that the dressing is clean and intact as well as date of last dressing change, assessing line necessity, daily CHG bath and connecting tubing to the line aseptically.
The hygiene bundle was implemented in 2017 and included: daily bath, appropriate mouth care each shift based on the patient’s age, cleaning high-touch surfaces each shift, and daily linen change.
Compliance with the insertion bundle and hygiene bundle was monitored based on documentation in the electronic medical record. Compliance with the maintenance bundle was based on nurse observations.