Impact of a New Dressing for the Prevention of Central Line-Associated Bloodstream Infections in a Neonatal Intensive Care Unit

Newborns in the neonatal intensive care unit (NICU) are incredibly vulnerable to infection due to their extremely fragile skin, underdeveloped immune system and common long-term hospitalisations. These infants often require the prolonged use of central venous catheters (CVCs) to supply them with drugs and nutrition. Each CVC dressing change can damage their fragile skin, increasing infection risk and resulting in central line-associated bloodstream infections (CLABSIs), the most common hospital-acquired infection in newborns and a major cause of death in the NICU. Current recommendations require dressing changes every seven days, more often if visibly damaged or dirty. Aiming to achieve the lowest possible CLABSI rates and reduce infant deaths, a new dressing designed for maintaining long-term skin adhesion was implemented in the Centre Hospitalier Universitaire Sainte-Justine (CHUSJ) NICU. The goal of this study is to assess the effectiveness of this new dressing alongside a reduction in dressing changes from every seven days to only when dirty or damaged. We will compare recorded rates of CLABSIs during a pre-intervention period from January 1, 2019 - December 31, 2022 to those following the post-intervention period from January 1, 2023 and continuing for at least twelve months. Recent reports indicate a concerning rebound of CLABSIs in NICUs due to COVID-19 pandemic impacts. Additionally, NICU outbreaks due to multidrug-resistant organisms are becoming more common, a critical issue as NICU patients are especially vulnerable to such infections and suffer worse outcomes following them. New infection prevention protocols will be crucial in the fight against the trend of rising CLABSI rates and severity of outcomes, especially for the incredibly fragile NICU population.