Safe and Effective in the NICU
Rady Children’s Hospital, San Diego, Calif.
272 Beds

Focusing on achieving a reduction in hospital-acquired bloodstream infection rates in the facility’s 41-bed NICU, Rady Children’s Hospital began an evaluation of Curos Port Protectors in October 2009 with both MicroClave® and SmartSite® needleless connectors.

During a six-month evaluation period the NICU used Curos disinfection caps on all central and PICC lines. The staff continued their normal practice of swabbing the needleless connector hubs on all lines, using the passive disinfection caps as an added protective measure. After five months, in an effort to standardize procedures, the protocol was amended to extend the use of Curos to all peripheral lines in the NICU.  The product evaluation process was also extended to all inpatient care areas.

The Rady NICU transport team added the use of Curos to dressing compliance checks on daily rounds of central lines in the NICU. This daily auditing process, along with the ease of use and visibility of Curos disinfection caps, has helped the facility achieve a 98 percent to100 percent compliance rate of Curos use in the NICU, driving positive outcomes for the hospital’s overall bloodstream infection rate.

As with most infection prevention initiatives, Rady Children’s found that front-line engagement is imperative to change. Likewise, the placement of Curos in strategic locations on the unit was extremely important. Stocking the port protectors near the patient so the nurse can access one easily at the bedside helps staff comply.

As Rady Children’s expanded the use of Curos throughout the hospital, stocking the port protectors outside the NICU raised questions as to whether young patients would play with the small product and if it could present a choking hazard. The secure luer-lock design of Curos helped to alleviate some of the concern and the facility chose to proceed with the house-wide roll out of Curos coupled with existing practices adopted for similar small devices such as restricting use with patients where it is felt to be contraindicated.

Other key components to Rady Children’s success include:

• Assigning the daily responsibility for auditing to the transport team, clinical educators, or designated clinical staff.
• Clearly communicating to clinical staff the overall benefits of using Curos to keep needleless connectors from becoming contaminated with pathogens–including pathogens found on the patients’ own skin.
• Forge partnerships with champion physicians, engaged clinical educators, and clinical leadership to support a bloodstream infection prevention initiative.

Although there are multiple variables to reducing bloodstream infection rates, Rady Children’s experience with using the Curos port protectors has been promising. After implementing Curos, the hospital reached 183 days without a BSI in our NICU, a historical first for the facility.

“Focusing our educational efforts on helping staff understand the product’s potential benefit to our line care is critical for success nurse can access one easily at the bedside – auditing and taking steps when compliance falls makes a real difference.”
Cindy Salgado, RN, CIC, infection control coordinator.