A statewide quality improvement collaborative to reduce neonatal central line-associated blood stream infections

D. D. Wirtschafter, J. Pettit, P. Kurtin, M. Dalsey, K. Chance, H. W. Morrow, M. Seid, T. L. Byczkowski, T. P. Huber, Jay M Milstein, S. M. Bowles, S. Fichera, S. Kloman

Research output: Contribution to journalArticlepeer-review

75 Scopus citations


Objective: The objective of this study was to reduce central line-associated blood stream infections (CLABSIs) among 13 collaborating regional neonatal intensive care units by 25%. We tested the hypothesis that change could be attributed to the quality improvement collaborative by testing for special cause variation. Study Design: Our prevention project included five features: (1) leadership commitment, (2) potentially best practices, (3) collaborative processes, (4) audit and feedback tools and (5) quality improvement techniques. Baseline (1 January 2006 to 30 August 2006) data were compared with the intervention (1 September 2006 to 30 June 2007) and post-intervention (1 July 2007 to 30 December 2007) periods and analyzed using statistical process control (SPC) methods. Result: We detected special cause variation, suggesting that the collaborative was associated with reduced infection rates, from 4.32 to 3.22 per 1000 line days (a 25% decrease) when comparing the baseline with the follow-up period. Conclusion: The collaborative's process was associated with fewer infections. SPC suggested that systematic changes occurred. The remaining challenges include sustaining or even further reducing the infection rate.

Original languageEnglish (US)
Pages (from-to)170-181
Number of pages12
JournalJournal of Perinatology
Issue number3
StatePublished - Mar 2010


  • Central line-associated blood stream infections
  • Collaborative networks
  • NICU
  • Quality improvement
  • Statistical process control

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Pediatrics, Perinatology, and Child Health


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