Association Between Central Line Practices and Bloodstream Infections in Palestinian Hospital's Neonatal Intensive Care Units: A Retrospective Study رسالة ماجستير

Abstract

Catheter-related bloodstream infections (CRBSI) and central line-associated bloodstream infections (CLABSI) are the two main classifications of bloodstream infections (BSIs) linked to Central venous catheters CVCs. In hospitalized neonates, healthcare-associated infections (HAIs) in neonatal intensive care units (NICUs) significantly increase morbidity and late mortality. To reduce infections linked to invasive medical equipment, numerous clinical guidelines have been developed. According to the Institute for Healthcare Improvement, "bundles" are groups of best practices related to a disease process that, when used collectively, significantly improve the quality of care. To examine the association between central line practices and bloodstream infections in Palestinian hospitals' NICUs. A retrospective, descriptive, quantitative study design was conducted at hospitals that contain NICUs. The target population was Newborns with central lines, who met the inclusion criteria. A convincing sample composed of (110) NICU neonates was included in the study during the data collection period. The most frequently utilized central lines (61.8%) are umbilical venous catheters (UVCs), which are mostly placed by neonatologists (74.5%), according to the findings. Despite the high rate of adherence to established insertion protocols (98.2%), there is still a lack of infection prevention strategies, such as the use of antiseptics (17.3%) and full barrier precautions (10.9%). Regular site inspections (92.7%) and mostly aseptic (50.9%) or sterile (47.3%) dressing changes are part of the strict central line management regimen. Candida spp. (25.5%) and Staphylococcus aureus (24.5%) are the most prevalent BSI pathogens; infections are cured in 56.4% of cases, but cause complications (12.7%) or death (9.1%) in other cases. CLABSI was significantly reduced (90.9%) as a result of staff education (27.3%) and care bundle implementation (66.4%). To further reduce BSIs, the study emphasizes the necessity of improved infection prevention strategies. This study emphasizes the connection between bloodstream infections in Palestinian NICUs and the usage of CVC. Stricter infection control methods are required to further minimize CLABSIs, even when procedure adherence is excellent. Strong surveillance, employee training, and ongoing quality improvement are crucial.