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Background Knowing the temporal trend central line–associated bloodstream infection (CLABSI) rates among U.S. pediatric intensive care units (PICUs), the current extent of central line bundle compliance, and the impact of compliance on rates is necessary to understand what has been accomplished and can be improved in CLABSI prevention. Methods This is a longitudinal study of PICUs in National Healthcare Safety Network hospitals and a cross-sectional survey of directors and managers of infection prevention and control departments regarding PICU CLABSI prevention practices, including self-reported compliance with elements of central line bundles. Associations between 2011-2012 PICU CLABSI rates and infection prevention practices were examined. Results Reported CLABSI rates decreased during the study period, from 5.8 per 1,000 line days in 2006 to 1.4 in 2011-2012 ( P Conclusion There was a nonsignificant trend in decreasing CLABSI rates as PICUs improved bundle policy compliance. Given that few PICUs reported full compliance with these policies, PICUs increasing their efforts to comply with these policies may help reduce CLABSI rates.

Background Bundles and checklists have been shown to decrease the rates of central line–associated bloodstream infections (CLABSIs), but implementation of these practices and association with CLABSI rates have not been described nationally. We describe implementation and levels of compliance with preventive practices in a sample of US neonatal intensive care units (NICUs) and assess their association with CLABSI rates. Methods An online survey assessing infection prevention practices was sent to hospitals participating in National Healthcare Safety Network CLABSI surveillance in October 2011. Participating hospitals permitted access to their NICU CLABSI rates. Multivariable regressions were used to test the association between compliance with NICU-specific CLABSI prevention practices and corresponding CLABSI rates. Results Overall, 190 level II/III and level III NICUs participated. The majority of NICUs had written policies (84%-93%) and monitored compliance with bundles and checklists (88%-91%). Reporting ≥95% compliance for any of the practices ranged from 50%-63%. Reporting of ≥95% compliance with insertion checklist and assessment of daily line necessity were significantly associated with lower CLABSI rates ( P Conclusions Most of the NICUs in this national sample have instituted CLABSI prevention policies and monitor compliance, although reporting compliance ≥95% was suboptimal. Reporting ≥95% compliance with select CLABSI prevention practices was associated with lower CLABSI rates. Future studies should focus on identifying and improving compliance with effective CLABSI prevention practices in neonates.