Abstract:
Background: Neonatal sepsis remains a critical concern in neonatal care, contributing significantly to morbidity and mortality. Aseptic techniques prevent infections during invasive procedures such as peripheral intravenous (IV) cannulation, particularly the aseptic non-touch technique (ANTT). The purpose of this study was to assess the baseline level of ANTT adherence among medical personnel and to analyze the effect of a structured educational intervention on compliance rates. The implementation of ANTT is based on the premise that having a standard framework and ensuring its compliance will decrease infection rates and consequently improve health care, especially in the resource-constrained setups of low- and middle-income countries (LMICs) Objectives The primary goal of this quality improvement project (QIP) is to assess baseline adherence to the ANTT during peripheral IV cannulation and evaluate improvement following a structured educational intervention using two Plan-Do-Study-Act (PDSA) cycles in the Neonatal Intensive Care Unit (NICU) at the Combined Military Hospital, Multan, Pakistan.
Methods: This QIP comprised two PDSA cycles to improve compliance with ANTT guidelines. Baseline data on adherence to aseptic practices were collected using a QI Surveillance Proforma to measure compliance. A structured educational intervention, which included presentations, video demonstrations, hands-on training, and competency assessments, was implemented over four months to improve compliance. The target audience included the NICU staff and nursing cadets. Compliance rates were measured post-intervention in both cycles using the same standardized checklist evaluating key aseptic practices.
Results: The compliance rates for peripheral IV cannulation were initially 66%. However, the analysis post-intervention showed a significant increase in compliance, with 89% median compliance after the first PDSA cycle and 94% after the second cycle. We saw that hand hygiene improved its adherence rates from 50% to 84%, while tray cleaning practices also improved from 64% to 87%. The overall adherence rate for peripheral IV cannulation showed an increase in rates to 92%. That is a huge improvement and shows targeted educational strategies can have a substantial impact.
Conclusion: This QIP highlights that carefully planned educational interventions, training, and hands-on practice can have on NICU healthcare providers’ adherence to aseptic procedures. We found that frequent skills assessments with uncomplicated, easy-to-remember procedures can ensure that our system operates near maximum efficiency.
Reference:Shahbaz A, Maqbool A, Imami F, Batool W, Asad AS, Shahbaz R. Assessing and Enhancing Adherence to the Standard Aseptic Non-touch Technique in Peripheral Intravenous Cannulation: A Quality Improvement Project in a Resource-Constrained Neonatal Intensive Care Unit. Cureus. 2025 Nov 13;17(11):e96730. doi: 10.7759/cureus.96730. PMID: 41245924; PMCID: PMC12616199.