Open AccessA quality improvement project to reduce intravenous catheter related infections in the neonatology unit of Kibogora hospital in Rwanda
Author(s) -
Jean Paul Nsengiyumva,
Rex Wong,
Eva Adomako,
Victor Pawelzik,
Julie Yerger,
Euphrosine Uwitonze,
Damien Nsabimana,
Sheila Etherngton,
Dariya Mukamusoni,
Laetitia Nyirazinyoye
Publication year - 2016
Publication title -
journal of hospital administration
Language(s) - English
Resource type - Journals
eISSN - 1927-7008
pISSN - 1927-6990
DOI - 10.5430/jha.v5n5p60
Subject(s) - medicine , guideline , quality management , neonatology , neonatal intensive care unit , emergency medicine , catheter , pediatrics , operations management , surgery , management system , pregnancy , pathology , biology , economics , genetics
In developing countries, intravenous (IV) catheter related infections (CRI) rate is generally high. Neonates are more susceptible to develop CRI. We examined the impact of a quality improvement project on IV CRI rates in the neonatal intensive care unit (NICU) of a district hospital in Rwanda. A pre- and post-intervention study was conducted from 2014 to 2016 to evaluate the IV CRI rate and nurses’ IV management technique. A written test was administered to evaluate their knowledge on the matter. The intervention had three components: First implementing an IV management policy. Secondly, training staff on the policy and finally, managers provided support and supervision during the change. We measured five indicators: (1) the IV CRI rate; (2) the percentage of nurses who tested 80% on IV management knowledge; (3) the percentage of IV devices changed following the World Health Organization (WHO) guideline; (4) IV management technique; and (5) the hospital length of stay (LOS). The IV CRI rate reduced from 32.1% to 14.5% (p < .001). The hospital LOS reduced from 15.31 to 7.43 days (p < .001). The compliance of changing IV following WHO guideline increased from 0% to 99% (p < .001); proper IV management technique use increased from 43% to 96% (p < .001); the mean rank of staff on IV management knowledge score significantly increased from 3.5 to 9.5 (p = .004). This project demonstrates that a quality improvement project can help address the IV CRI at very low cost in a resource-challenged setting.