The clinical experience of continuous quality improvement in the neonatal intensive care unit

Central line catheters are commonly placed in extremely low-birthweight inf ants to provide venous access for administration of hyperalimentation and m edications. Infection is the most common complication of central line cathe ters in this patient population. With expansion of the neonatal intensive c are unit at Allegheny General Hospital and an increase in the number of inf ants weighing less than 1000 g, there was a proportionate increase in the n umber of central line catheter days. A multidisciplinary team formed to imp rove central line care practices to reduce the rate of line infections. The continuous quality improvement process was used to modify central line pra ctices, which led to a decrease in the rate of central line infections. For the first 8 months of 1997, the infection rate was below the 25th percenti le according to the National Nosocomial Infections Surveillance System data .