Primary Children’s Hospital NICU reduces central line infections

Before the year started, leaders in the neonatal intensive care unit at Primary Children’s Hospital in Salt Lake City, Utah decided to focus on reducing central line infections. 

So far in 2025, they have succeeded in reducing those infections by 66%, said NICU nurse manager Allison Struiksma, RN.  

“My team, along with Kaylie Grant, RN, our infection prevention clinical expanded role NICU nurse, and our provider team, decided we needed to figure out something to reduce our CLABSI rates,” Allison said, referring to central line-associated bloodstream infections. “Obviously it was important for patient safety, and we wanted to make sure we were following our protocols and practices appropriately.” 

Kaylie led the work, starting with education and reminders about the requirements on Primary Children’s NICU. Many of the infant patients there are immunocompromised. 

The team reviewed rules related to hand hygiene, jewelry restrictions and fingernail policy. They also encouraged all team members to “speak up for safety” and remind caregivers who are rarely on the unit about the rules. 

Beyond education, nurses began using an antiseptic called Prevantics in addition to alcohol swabs to clean lines. Kaylie also created a flash card game based on infection prevention questions. She would round and ask the questions to caregivers, offering candy prizes for correct answers. 

“I wanted to find a way to chat one-on-one with staff about our infection prevention practices,” Kaylie said. “We have unique challenges in the NICU with a large staff, immunocompromised patients, and high line days. The candy just helps me catch attention and make it fun.” 

Although other Level 3 and Level 4 NICUs could mimic many of these techniques, Primary Children’s is one of the few locations to employ tele critical care nurses, who watch babies remotely via camera. The TCC nurses conduct audits of care and Kaylie had them focus on central line safety. The TCC nurses would chart safety measures and check in with the nurses about specific cases. 

“We really tackled it from a lot of angles, and one of the reasons for success was that we got everybody involved,” Allison said. “It takes all of us to prevent infections, so I’m impressed whenever people can come together and do that as a group.” 

Kaylie called out the nurses on the floor for their positive response. She plans to continue to round with the flash cards on important topics. 

The achievement is the result of focused interventions and a renewed commitment to best practices: 

• Back to basics: Weekly newsletters and monthly safety topics kept CLABSI prevention top-of-mind for everyone in the unit. 
• Culture change: Open discussions on the pods and unit, increased awareness from newsletters and TCC audits, ongoing CLABSI classes for new hires, and regular updates on new CLABSI cases and current rates all contributed to a culture of safety and accountability. 
• Rounding cart: Staff engaged in low-stress, fun protocol reviews on the pods, using question cards to spark discussion and deepen understanding of the “why” behind best practices. 
• Prevantics wipes: Consistent use of Prevantics wipes on all central lines has become the norm, and we suspect this consistency has played a key role in our success.