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Purpose Statement:

NICU patients have a decreased risk of CLABSI infections when two-person sterile central line changes are implemented into central line maintenance bundles compared to bundles that only use one-person clean line change techniques.


Neonates admitted to the neonatal care intensive care unit (NICU) often require the placement of central lines for the administration of medications, fluids, parental nutrition, and hemodynamic monitoring. Despite their many advantages, central lines can lead to serious infections, known as cental line associated bloodstream infections (CLABSI). These infections are not related to an infection from another site and develop within forty-eight hours of removal. CLABSIs are a major contributor to morbidity and mortality in the NICU population and are costly to hospital systems. According to Mobley & Bizzarro, infants who develop CLABSIs can cost up to an additional $50,000 and add as many as ten days to their hospital stay when compared to other infants without CLABSIs (2017). An evidence-based approach that has shown to improve patient outcomes and reduce CLABSIs is the use of a bundle, which is utilized upon insertion and during maintenance of the central line. Based on the available research, the most common CLASBI bundle elements include: using maximum standard barrier precautions, using a specific skin preparation & line dressing protocol, daily central line need assessments, a two-person line change technique, specific education and training for staff, and quarterly audits (Payne et al., 2018). The St. Cloud Hospital NICU currently utilizes these practices expect for a two-person line change with sterile technique.

Publication Date

Spring 2023




St. Cloud, MN


CLABSI, Central line-associated bloodstream infections, NICU, Neonatal intensive care unit, Central line bundle, CVC infections


Maternal, Child Health and Neonatal Nursing | Other Nursing


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