From Concern to Control: Feedback from a quality improvement project to decrease Central-Line–Associated Bloodstream Infections in a Tertiary Neonatal Intensive Care Unit"

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Published Nov 9, 2025
https://doi.org/10.62438/tunismed.v103i9.5962
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Vol. 103 No. 9 (2025): Tunis Med sept 2025

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Nabiha Ahmad Bouafia
Infection Prevention and Control Centre of Excellence – Prince Sultan Military Medical City – Riyadh 12233, Kingdom of Saudi Arabia University of Sousse - Faculty of Medicine – Sousse 4002, Tunisia
Ahmed Elabbasy
Neonatal Intensive Care Unit – Prince Sultan Military Medical City – Riyadh 12233 –, Kingdom of Saudi Arabia
Dalal Albukhari
Infection Prevention and Control Centre of Excellence – Prince Sultan Military Medical City – Riyadh 12233, Kingdom of Saudi Arabia
Maechel Joy Santiago
Infection Prevention and Control Centre of Excellence – Prince Sultan Military Medical City – Riyadh 12233, Kingdom of Saudi Arabia
Reham AlWeteshi
Infection Prevention and Control Centre of Excellence – Prince Sultan Military Medical City – Riyadh 12233, Kingdom of Saudi Arabia
Mohammed Althomali
Infection Prevention and Control Centre of Excellence – Prince Sultan Military Medical City – Riyadh 12233, Kingdom of Saudi Arabia
Yassir K Mohamed
Infection Prevention and Control Centre of Excellence – Prince Sultan Military Medical City – Riyadh 12233, Kingdom of Saudi Arabia
Aliyah Al Qarni
Neonatal Intensive Care Unit – Prince Sultan Military Medical City – Riyadh 12233 –, Kingdom of Saudi Arabia
Jennifer Echevarria
Neonatal Intensive Care Unit – Prince Sultan Military Medical City – Riyadh 12233 –, Kingdom of Saudi Arabia
Hussem Al Hussien
Supply Department – Prince Sultan Military Medical City – Riyadh 12233, Kingdom of Saudi Arabia
Salem Saleh Alawad
Continuous Quality Improvement Department – Prince Sultan Military Medical City – Riyadh 12233, Kingdom of Saudi Arabia
Fawaz Kashlan
Neonatal Intensive Care Unit – Prince Sultan Military Medical City – Riyadh 12233 –, Kingdom of Saudi Arabia
Abdulrahman Alodyani
Infection Prevention and Control Centre of Excellence – Prince Sultan Military Medical City – Riyadh 12233, Kingdom of Saudi Arabia

Abstract

Introduction: Infants admitted in Neonatal Intensive Care units (NICU) are frequently exposed to a high risk of contracting a central line-associated bloodstream infection (CLABSI). The study aims to reduce the CLABSI rate in the NICU to reach the Saudi Ministry of Health (MOH) benchmark.


Methods: It is a quality improvement project based on the Plan Do Check Act. This study was conducted in the Neonatal intensive care unit (NICU) at the Prince Sultan Military Medical City. The study was done from February 2023 to July 2023 in NICU. Sixteen evidence-based recommendations were assessed over the project. An assigned team enhanced the regular assessment of central line-related items and supplies.
Results: 38 staff members were selected as 'a vascular access team' for this project. Full compliance with updated recommendations increased from 25% to 56.3%, and overall care bundle compliance improved from 66.07% to 79.12%. The availability of supplies related to central lines improved throughout the CLABSI project. Consequently, the CLABSI rate decreased by 82.3%, from 10.42 (6 CLABSI, 576 central line days; February 2023) to 1.84 (1 CLABSI, 544 central line days; July 2023) CLABSI per 1,000 central line days after six months of quality improvement project implementation.
Conclusions: Reducing the CLABSI rate is achievable by QIP based on updated recommendations to improve the quality of care and outcomes for newborns. However, multiple challenges should be addressed to maintain a low CLABSI rate.

Keywords:

Central line, associated bloodstream infections , Quality improvement project , Neonatal intensive care unit

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Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Author Biography

Nabiha Ahmad Bouafia, Infection Prevention and Control Centre of Excellence – Prince Sultan Military Medical City – Riyadh 12233, Kingdom of Saudi Arabia University of Sousse - Faculty of Medicine – Sousse 4002, Tunisia

MD, Msc, CIC

Infection Prevention and Control Consultant in Infection Prevention and Control Centre of Excellence at PSMMC, Riyadh - Saudi Arabia 

Asscociate Professor in Preventive Medicine (Faculty of Medicine of Sousse, Tunisia)

 

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