ArticlePediatrics2011
Statewide NICU central-line-associated bloodstream infection rates decline after bundles and checklists.
Article in Pediatrics, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02598609 (Study on Preventing Adverse Events in Neonates), which is not on this map. Cited by 96 papers, 7 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Study on Preventing Adverse Events in Neonates (SEPREVEN): a Stepped-wedge Randomised Controlled Trial to Reduce Adverse Event Rates in the NICU
Who cites it
96 citing papers in PubMed, 7 syntheses or guidelines pooled it.
- Early planned removal versus expectant management of peripherally inserted central catheters to prevent infection in newborn infants.The Cochrane database of systematic reviews · 2018Pooled it
- Antibiotics at the time of removal of central venous catheter to reduce morbidity and mortality in newborn infants.The Cochrane database of systematic reviews · 2018Pooled it
- Early planned removal of umbilical venous catheters to prevent infection in newborn infants.The Cochrane database of systematic reviews · 2017Pooled it
- Heteroresistant Vancomycin Intermediate Coagulase Negative Staphylococcus in the NICU: A Systematic Review.PloS one · 2016Pooled it
- Antimicrobial-impregnated central venous catheters for prevention of catheter-related bloodstream infection in newborn infants.The Cochrane database of systematic reviews · 2015Pooled it
- Antibiotic lock for the prevention of catheter-related infection in neonates.The Cochrane database of systematic reviews · 2015Pooled it
- Neonatal severe bacterial infection impairment estimates in South Asia, sub-Saharan Africa, and Latin America for 2010.Pediatric research · 2013Pooled it
- Study draft: "UVC-You Will See" study: longer vs. shorter umbilical venous catheter (UVC) dwell time (6-10 vs. 1-5 days) in very premature infants with birth weight < 1250 g and/or gestational age < 30 weeks.Wiener medizinische Wochenschrift (1946) · 2024Trial
- Utilization of a patient-centered asthma passport tool in a subspecialty clinic.The Journal of asthma : official journal of the Association for the Care of Asthma · 2018Trial
- Prevention of neonatal late-onset sepsis: a randomised controlled trial.BMC pediatrics · 2017Trial
- Daily chlorhexidine bathing to reduce bacteraemia in critically ill children: a multicentre, cluster-randomised, crossover trial.Lancet (London, England) · 2013Trial
- Implementation of a central line maintenance care bundle in hospitalized pediatric oncology patients.Pediatrics · 2012Trial
- Closed multilumen infusion system reduces CLABSI and antibiotic exposure in very preterm neonates.BMJ paediatrics open · 2026Article
- Risk factors for BPD and relevant nursing models of care to improve outcomes: a narrative review.Frontiers in pediatrics · 2026Review
- A Quality Improvement Bundle to Reduce Central Line-Associated Bloodstream Infections in Neonatal Intensive Care Unit: An Observational Study.Antibiotics (Basel, Switzerland) · 2025Article
- Observational
- Meaningfulness, feasibility, and usability of quality-of-care measures for maternal and infant health: A structured mixed-methods review.Journal of clinical and translational science · 2025Article
- Racial and Ethnic Differences in Outcomes of Neonates Born at Less Than 30 Weeks' Gestation, 2018-2022.JAMA network open · 2024Article
- Quality improvement initiative 'S-A-F-H' to reduce healthcare-associated neonatal sepsis in a tertiary neonatal care unit.BMJ open quality · 2024Article
- Umbilical venous catheter- and peripherally inserted central catheter-associated complications in preterm infants with birth weight < 1250 g : Results from a survey in Austria and Germany.Wiener medizinische Wochenschrift (1946) · 2023Article
36 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
14 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveIn 2008, all 18 regional referral NICUs in New York state adopted central-line insertion and maintenance bundles and agreed to use checklists to monitor maintenance-bundle adherence and report checklist use. We sought to confirm whether adopting standardized bundles and using central-line maintenance checklists reduced central-line-associated bloodstream infections (CLABSI).
methodsThis was a prospective cohort study that enrolled all neonates with a central line who were hospitalized in any of 18 NICUs. Each NICU reported CLABSI and central-line utilization data and checklist use. We used χ(2) to compare CLABSI rates in the preintervention (January to December 2007) versus the postintervention (March to December 2009) periods and Poisson regression to model adjusted CLABSI rates.
resultsEach study period included more than 55 000 central-line days and more than 200 000 patient-days. CLABSI rates decreased 67% statewide (risk ratio: 0.33 [95% confidence interval: 0.27-0.41]; P < .0005); after adjusting for the altered central-line-associated bloodstream infection definition in 2008, by 40% (risk ratio: 0.60 [95% confidence interval: 0.48-0.75]; P < .0005). A total of 13 of 18 NICUs reported using maintenance checklists for 10% to 100% of central-line days. The checklist-use rate was associated with the CLABSI rate (coefficient: -0.57, P = .04). A total of 10 of 18 NICUs were independent CLABSI rate predictors, ranging from 1 site with greatly reduced risk (incidence rate ratio: 0.04, P < .0005) to 1 site with greatly increased risk (incidence rate ratio: 2.87, P < .0005).
conclusionsAlthough standardizing central-line care elements led to a significant statewide decline in NICU CLABSIs, site of care remains an independent risk factor. Using maintenance checklists reduced CLABSIs.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.