Alcohol-impregnated port protectors to reduce central line-associated bloodstream infection in the neonatal intensive care unit: a quality improvement study
Alcohol-impregnated port protectors to reduce central line-associated bloodstream infection in the neonatal intensive care unit: a quality improvement study
Objective: to investigate the effect of alcohol-impregnated port protectors (AIPPs) on neonatal central line-associated bloodstream infection (CLABSI) rates.
Design: a quality improvement study.
Setting: a tertiary neonatal unit in the UK.
Patients: babies >72 hours of age with a central line.
Intervention: AIPPs were applied to intravascular access ports not allocated for fluid infusion from March 2018 to February 2020. Daily audits were performed for 3 months postimplementation, with quarterly audits thereafter.
Main outcome measures: CLABSI rates were calculated pre-implementation and post-implementation with a 3-month washout period (March–May 2018). Logistic regression was used to analyse the risk of CLABSIs between periods, adjusting for important differences between cohorts.
Results: there was no difference in overall CLABSI rates per 1000 central lines days between the pre-implementation and post-implementation periods (5.5 vs 6.6, p=0.5). However, rates of CLABSI involving confirmed pathogens rather than coagulase-negative Staphylococcus (CoNS) were higher postimplementation (0.5 vs 2.7, p=0.012). After adjusting for birth weight, gestational age at birth, gender, central line duration and length of stay, there were no significant differences in the overall risk of CLABSI between the two periods (OR 1.05, 95% CI 0.57 to 1.91, p=0.886) or the risk of CLABSI involving pathogens (OR 3.54 95% CI 0.77 to 16.06, p=0.102) or CoNS (OR 0.76 95% CI 0.39 to 1.46, p=0.406).
Conclusions: AIPPs did not result in reduced CLABSI rates. The use of AIPPs cannot currently be recommended.
Intensive Care Units, Neonatal, Neonatology, Nursing, Sepsis, Technology
Payne, Vicky
e8d0b37f-b13e-4990-871f-c60def347dd8
Hall, Mike
9b20bf5c-646c-45d0-8c81-4e2779cea440
Johnson, Mark John
64135487-45a1-46a6-a34b-595143e3c9a6
2 May 2025
Payne, Vicky
e8d0b37f-b13e-4990-871f-c60def347dd8
Hall, Mike
9b20bf5c-646c-45d0-8c81-4e2779cea440
Johnson, Mark John
64135487-45a1-46a6-a34b-595143e3c9a6
Payne, Vicky, Hall, Mike and Johnson, Mark John
(2025)
Alcohol-impregnated port protectors to reduce central line-associated bloodstream infection in the neonatal intensive care unit: a quality improvement study.
Archives of Disease in Childhood - Fetal and Neonatal Edition, [327651].
(doi:10.1136/archdischild-2024-327651).
Abstract
Objective: to investigate the effect of alcohol-impregnated port protectors (AIPPs) on neonatal central line-associated bloodstream infection (CLABSI) rates.
Design: a quality improvement study.
Setting: a tertiary neonatal unit in the UK.
Patients: babies >72 hours of age with a central line.
Intervention: AIPPs were applied to intravascular access ports not allocated for fluid infusion from March 2018 to February 2020. Daily audits were performed for 3 months postimplementation, with quarterly audits thereafter.
Main outcome measures: CLABSI rates were calculated pre-implementation and post-implementation with a 3-month washout period (March–May 2018). Logistic regression was used to analyse the risk of CLABSIs between periods, adjusting for important differences between cohorts.
Results: there was no difference in overall CLABSI rates per 1000 central lines days between the pre-implementation and post-implementation periods (5.5 vs 6.6, p=0.5). However, rates of CLABSI involving confirmed pathogens rather than coagulase-negative Staphylococcus (CoNS) were higher postimplementation (0.5 vs 2.7, p=0.012). After adjusting for birth weight, gestational age at birth, gender, central line duration and length of stay, there were no significant differences in the overall risk of CLABSI between the two periods (OR 1.05, 95% CI 0.57 to 1.91, p=0.886) or the risk of CLABSI involving pathogens (OR 3.54 95% CI 0.77 to 16.06, p=0.102) or CoNS (OR 0.76 95% CI 0.39 to 1.46, p=0.406).
Conclusions: AIPPs did not result in reduced CLABSI rates. The use of AIPPs cannot currently be recommended.
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AIPP Manuscript ADC 07 03 2025 v2 Main document
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Accepted/In Press date: 18 April 2025
e-pub ahead of print date: 2 May 2025
Published date: 2 May 2025
Keywords:
Intensive Care Units, Neonatal, Neonatology, Nursing, Sepsis, Technology
Identifiers
Local EPrints ID: 502640
URI: http://eprints.soton.ac.uk/id/eprint/502640
ISSN: 1359-2998
PURE UUID: 6d336f7c-515a-4931-8dc2-62a8edd8305c
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Date deposited: 02 Jul 2025 17:00
Last modified: 11 Sep 2025 03:03
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Author:
Mike Hall
Author:
Mark John Johnson
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