{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T11:32:30Z","timestamp":1787657550703,"version":"build-2736575974"},"reference-count":18,"publisher":"American Academy of Pediatrics (AAP)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2011,3,1]]},"abstract":"<jats:sec>\n                  <jats:title>OBJECTIVE:<\/jats:title>\n                  <jats:p>We aimed to reduce late-onset bacterial infections in infants born at 22 to 29 weeks' gestation by using collaborative quality-improvement methods to implement evidence-based catheter care. We hypothesized that these methods would result in a 50% reduction in nosocomial infection.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>PATIENTS AND METHODS:<\/jats:title>\n                  <jats:p>We conducted an interrupted time-series study among 24 Ohio NICUs. The intervention began in September 2008 and continued through December 2009. Sites used the Institute for Healthcare Improvement Breakthrough Series quality-improvement model to facilitate implementation of evidence-based catheter care. Data were collected monthly for all catheter insertions and for at least 10 observations of indwelling catheter care. NICUs also submitted monthly data on catheter-days, patient-days, and episodes of infection. Data were analyzed by using statistical process control methods.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS:<\/jats:title>\n                  <jats:p>During the intervention, NICUs submitted information on 1916 infants. Of the 242 infections reported, 69% were catheter associated. Compliance with catheter-insertion components was &amp;gt;90% by April 2009. Compliance with components of evidence-based indwelling catheter care reached 80.4% by December 2009. There was a significant reduction in the proportion of infants with at least 1 late-onset infection from a baseline of 18.2% to 14.3%.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS:<\/jats:title>\n                  <jats:p>There was a 20% reduction in the incidence of late-onset infection after the intervention, but the magnitude was less than hypothesized, perhaps because compliance with components of evidence-based care of indwelling catheters remained &amp;lt;90%. Because nearly one-third of infections were not catheter associated, improvement may require attention to other aspects of care such as skin integrity and nutrition.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1542\/peds.2010-2141","type":"journal-article","created":{"date-parts":[[2011,2,22]],"date-time":"2011-02-22T08:43:10Z","timestamp":1298364190000},"page":"427-435","source":"Crossref","is-referenced-by-count":128,"title":["Ohio Statewide Quality-Improvement Collaborative to Reduce Late-Onset Sepsis in Preterm Infants"],"prefix":"10.1542","volume":"127","author":[{"given":"Heather C.","family":"Kaplan","sequence":"first","affiliation":[{"name":"Perinatal Institute and"},{"name":"James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carole","family":"Lannon","sequence":"additional","affiliation":[{"name":"Division of Neonatology, Case Western Reserve University, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele C.","family":"Walsh","sequence":"additional","affiliation":[{"name":"Division of Neonatology, Case Western Reserve University, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward F.","family":"Donovan","sequence":"additional","affiliation":[{"name":"James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"for the Ohio Perinatal Quality Collaborative","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2011,3,1]]},"reference":[{"issue":"1","key":"2021121007013915200_B1","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1542\/peds.109.1.34","article-title":"Epidemiological, clinical, and microbiological characteristics of late-onset sepsis among very low birth weight infants in Israel: a national survey","volume":"109","author":"Makhoul","year":"2002","journal-title":"Pediatrics"},{"issue":"2 pt 1","key":"2021121007013915200_B2","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1542\/peds.110.2.285","article-title":"Late-onset sepsis in very low birth weight neonates: the experience of the NICHD Neonatal Research Network","volume":"110","author":"Stoll","year":"2002","journal-title":"Pediatrics"},{"issue":"6","key":"2021121007013915200_B3","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1097\/00006454-200206000-00006","article-title":"Variations in central venous catheter-related infection risks among Canadian neonatal intensive care units","volume":"21","author":"Chien","year":"2002","journal-title":"Pediatr Infect Dis J"},{"issue":"3","key":"2021121007013915200_B4","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1016\/j.ajic.2006.01.002","article-title":"Risk factors for late-onset health care-associated bloodstream infections in patients in neonatal intensive care units","volume":"35","author":"Perlman","year":"2007","journal-title":"Am J Infect Control"},{"issue":"26","key":"2021121007013915200_B5","doi-asserted-by":"crossref","first-page":"2725","DOI":"10.1056\/NEJMoa061115","article-title":"An intervention to decrease catheter-related bloodstream infections in the ICU","volume":"355","author":"Pronovost","year":"2006","journal-title":"N Engl J Med"},{"issue":"2","key":"2021121007013915200_B6","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1542\/peds.2009-1382","article-title":"Decreasing PICU catheter-associated bloodstream infections: NACHRI's quality transformation efforts","volume":"125","author":"Miller","year":"2010","journal-title":"Pediatrics"},{"key":"2021121007013915200_B7","unstructured":"Ohio Perinatal Quality Collaborative Writing Committee. Collaborative improvement of population perinatal health in Ohio: study design, methods, and provider site participation. Available at: www.opqc.net\/sites\/bmidrupalpopqc.chmcres.cchmc.org\/files\/docs\/articles\/EdManuscript.pdf. 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