Strategies to reduce hospital-associated bloodstream infections in a limited resource setting: Preventing Infections in Neonates (PIN) collaborative

Abstract Background: Hospitalized neonates are at high risk for hospital-associated bloodstream infections (HA-BSI) and require locally contextualized interventions to prevent HA-BSI. Methods: The Preventing Infections in Neonates (PIN) collaborative aimed reach a 50% decrease neonatal HA-BSI rates 27-bed Level IV intensive care unit (NICU). Using quality improvement (QI) methodologies, multidisciplinary cross-cultural implemented phased bundled from July 2017 September 2019. Descriptive statistics statistical process control charts were used analyze infection rates. Results: There 916 admissions, 19,812 patient-days, 4264 central line days the NICU during project period. Monthly baseline preintervention median rate was 3.95/1000 patient-days decreased 1.73/1000 (56% change) interventions. Quarterly also of 4.5/1000 3.3/1000 intervention period (IRR 0.73; 95%CI 0.39, 1.36). Staff highly compliant with hand hygiene environmental cleaning. Through efforts, compliance bundle elements increased 25% peak 97% (CL) insertion checklists 13% 56% CL maintenance checklists. Conclusions: Unit-based can reduce limited resource settings. Future studies assess similar practices other units impact pandemic on HA-BSIs.