A Quality improvement initiative to reduce central line-associated bloodstream infections in a neonatal intensive care unit in a low-and-middle-income country.

Background: Premature and sick neonates in the neonatal intensive care unit (NICU) are in need of central lines placing them at high risk of contracting a central line-associated bloodstream infection (CLABSI). CLABSI extends length of stay to 10-14 days post negative cultures and increases morbidity, use of multiple antibiotics, mortality and hospital cost. To reduce CLABSI rate at the American University of Beirut Medical Center NICU, the National Collaborative Perinatal Neonatal Network developed a quality improvement project to reduce CLABSI rate by 50% over a 1-year period and to sustain reduced CLABSI rate.

A grid to assess the nutritional status of low-birth-weight infants in the neonatal period.

Growth curves of low-birth-weight infants updated over the past 50 years accept many exclusions and do not provide a standard way to assess the nutritional status of these infants regardless of their diseases in the neonatal period. A new way for assessment is proposed. It is based on the excess time expressed in percent beyond the allocated time for an infant to gain his birth weight and the excess drop in weight expressed in percent beyond the allowed drop of weight.