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Discussion

Do you wipe down IV lines to help prevent CLABSI in the NICU?

Have any suggestion improving CLABSI rates?

We are looking at different ways to improve our CLABSI rates in our Level IV NICU. Does anyone wipe down or clean the baby's IV lines daily, especially the part of the lines lying in the bed nearest to the baby?  We use the purple or grey topped sani cloths to wipe down equipment in the baby's bedspace each shift but not on the IV lines.

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    Whatever a unit does, it should be based on evidence from clinical trials, not stuff that just sounds like a good idea. More time consuming busywork has been thrust on bedside nurses because it makes intuitive sense, but is at best ineffective and at worst introduces unanticipated consequences. What is your line infection rate? Do you have a 100%  before/after patient contact handwashing rate? If not, start there. 

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    There is evidence to support daily CHG bathing, to include wiping line dressings and the first 6 inches of all lines, tubes, and drains in both adult and pediatric ICUs in reducing the occurrence of CLABSI.  I am unsure whether the literature supports this in the NICU for those patients in whom CHG is not contraindicated.

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    Like the authors say, it's important to monitor infection rates long term. If nurses hands, for example, are exposed to CHG several times per shift, is this the reason for the fall in line infections? Lots of questions there. 

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