Qualitative process evaluation of a central line-associated bloodstream infection (CLABSI) prevention team in the neonatal intensive care unit

Background: A central line-associated bloodstream infection (CLABSI) is a serious complication. Patients in the neonatal intensive care unit (NICU) are at increased risk for CLABSI, and hospitals often implement patient safety initiatives to prevent them. Studies have quantitatively demonstrated that line teams can reduce the rate of CLABSI. The purpose of this study was to qualitatively assess the function of the line team.

Methods: Participants of the study were recruited from the NICU of a large children's hospital in Texas. Each participant provided oral consent to participate, and interviews were captured on audio recorder and transcribed. Thematic content analysis was used to evaluate the data.

Results: We found that successful infection prevention requires collaborative work with all personnel in the NICU. We also found that line team personnel function as an extra level of support for bedside nurses, provide guidance on protocols, and serve as educators and trainers. Lastly, we heard several situations in which the essential function of the line team to prevent CLABSI is threatened by other necessary operations of the unit.

Conclusions: It is important for infection prevention initiatives to not only track and measure outcomes, but also consider the processes during implementation. This study provides important insight into the operation of the line team that should be contemplated by hospitals seeking to implement a similar initiative.