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Am J Perinatol. 2017 Aug;34(10):1032-1040. doi: 10.1055/s-0037-1601563. Epub 2017 Apr 10.

Teamwork in the NICU Setting and Its Association with Health Care-Associated Infections in Very Low-Birth-Weight Infants.

Author information

1
Perinatal Epidemiology and Health Outcomes Research Unit, Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University and Lucile Packard Children's Hospital, Palo Alto, California.
2
California Perinatal Quality Care Collaborative, Palo Alto, California.
3
Center for Quality and Clinical Effectiveness, Lucile Packard Children's Hospital, Palo Alto, California.
4
Division of Hospitalist Medicine, Department of Pediatrics, Stanford University, Palo Alto, California.
5
Department of Pediatrics Research and Statistical Unit, Stanford University, Palo Alto, California.
6
Quantitative Sciences Unit, Department of Pediatrics, Stanford University, Palo Alto, California.
7
Division of Pediatric Critical Care Medicine, Department of Pediatrics, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto, California.
8
University of Texas at Houston-Memorial Hermann Center for Healthcare Quality and Safety, University of Texas Medical School, Houston.
9
Department of Psychiatry, Duke University School of Medicine, Duke University Health System, Durham.
10
Duke Patient Safety Center, Duke University Health System, Durham.

Abstract

Background and Objective Teamwork may affect clinical care in the neonatal intensive care unit (NICU) setting. The objective of this study was to assess teamwork climate across NICUs and to test scale-level and item-level associations with health care-associated infection (HAI) rates in very low-birth-weight (VLBW) infants. Methods Cross-sectional study of the association between HAI rates, defined as any bacterial or fungal infection during the birth hospitalization, among 6,663 VLBW infants cared for in 44 NICUs between 2010 and 2012. NICU HAI rates were correlated with teamwork climate ratings obtained in 2011 from 2,073 of 3,294 eligible NICU health professionals (response rate 63%). The relation between HAI rates and NICU teamwork climate was assessed using logistic regression models including NICU as a random effect. Results Across NICUs, 36 to 100% (mean 66%) of respondents reported good teamwork. HAI rates were significantly and independently associated with teamwork climate (odds ratio, 0.82; 95% confidence interval, 0.73-0.92, p = 0.005), such that the odds of an infant contracting a HAI decreased by 18% with each 10% rise in NICU respondents reporting good teamwork. Conclusion Improving teamwork may be an important element in infection control efforts.

PMID:
28395366
PMCID:
PMC5798868
DOI:
10.1055/s-0037-1601563
[Indexed for MEDLINE]
Free PMC Article

Conflict of interest statement

Funding: This work was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01 HD084679–01, Co-PI: Sexton and Profit and K24 HD053771–01, PI: Thomas), Texas Children's Hospital (Pediatrics Pilot Research Fund 33–126, PI: Profit) where Dr. Profit worked at the time of this research. Dr. Tawfik's effort was supported by the Jackson Vaughan Critical Care Research Fund. Conflict of Interest None.

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