Name: Vicky Payne
Job Title: Advanced Neonatal Nurse Practitioner and Visiting Fellow
Title of talk: Care bundles to reduce CLABSIs in the Neonatal Unit
Biographical Sketch: Vicky has worked clinically as an ANNP since her qualification in 2012. She is currently employed as an ANNP at the Princess Anne Hospital, University Hospital Southampton, where she works on the middle-grade medical rota, including the SoNET transport retrieval team. She is an independent nurse prescriber, and is currently completing a non-medical authorisation of blood products portfolio. Her interests are focused upon research, education and local quality improvement, and she has recently been involved in developing a care bundle aimed at reducing bloodstream infection rates. Vicky is also undertaking a Doctorate in Clinical Practice programme at the University of Southampton, which is focused on the implementation of care bundles to reduce neonatal bloodstream infections. She has received two professional bursary awards from the RCN Foundation Trust, as well as support for her project from the charity Bliss.


Her passion for sharing knowledge has evolved from clinical teaching to undertaking a secondment in 2014 with the University of Southampton, where she now teaches for 40% of her time on the Advanced Neonatal Clinical Practice MSc programme. In 2017, she completed her Post-Graduate teaching qualifications, and now helps to facilitate the neonatal Evidence-Based Practice module.


She has recently returned from Vietnam, where she worked for two weeks as a volunteer for the Newborns Vietnam scheme, helping to deliver clinical education and training for neonatal nurses.


Lecture Abstract: Central line-associated bloodstream infections (CLABSIs) are associated with increased mortality, morbidity and prolonged hospitalisation. Complex interventions, such as care bundles, are interventions that have multiple interacting components, and have been shown to reduce CLABSIs in adult ICUs, demonstrated in the seminal Michigan Keystone project.   Whilst this quality improvement work showed that zero CLABSI rates were achievable, attempts to replicate this success in the UK have had mixed success. The Matching Michigan study, whilst reducing paediatric CLABSI rates by 45%, failed to reach statistical significance, and this was felt to be due to variations and small numbers.   However, this trial had challenges in out-performing the secular trend, and there were notable differences in team engagement.


This session will provide a critique of the current evidence on the effectiveness of care bundles to reduce CLABSIs in the neonatal unit, presenting the results of a systematic review and meta-analysis. It will outline the most common bundled elements used in these studies, and will consider how local teams may translate this evidence into local practice.

References: Dixon-Woods M, Bosk CL, Aveling EL, Goeschel CA and Pronovost PJ (2011) Explaining Michigan: developing an ex post theory of a quality improvement program. Milbank Q 89(2): 167-205


Dixon-Woods M, Leslie M, Tarrant C and Bion J (2013) Explaining Matching Michigan: an ethnographic study of a patient safety program. Implement Sci 8: 70


Pronovost P, Needham D, Berenholtz S, Sinopoli D, Chu H, Cosgrove S, Sexton B, Hyzy R, Welsh R, Roth G, Bander J, Kepros J and Goeschel C (2006) An intervention to decrease catheter-related bloodstream infections in the ICU. N Engl J Med 355