In the neonatal intensive care unit (NICU), intubated newborns rely on vigilant nursing to protect them during their most vulnerable moments. Small actions carried out with consistency can make a profound difference in preventing infections and keeping fragile patients safe.
At UCHealth University of Colorado Hospital, that commitment to infection prevention was already woven into daily NICU care. As patient needs and care teams expanded, NICU nurse Laura Renner, BSN, RN, C‑ELBW, saw an opportunity to reinforce and sustain those efforts through her UEXCEL Level III project.
With a respiratory infection prevention bundle in place and nurses deeply committed to caring for intubated infants, Renner focused on strengthening reliability and visibility in an increasingly complex care environment. Rather than introducing a new process, she worked to bring renewed clarity and a nurse-led focus to the essential infection prevention practices NICU staff rely on every day.
Early insights from the project affirmed the effectiveness of the unit’s existing approach. Pre-education feedback demonstrated high awareness of the prevention bundle and strong adherence to many core elements. The feedback also revealed opportunities to further improve consistency in more complex or time sensitive steps, particularly during complicated or emergent situations common in neonatal care.
To support long term reliability, Renner led a coordinated, unit wide multidisciplinary initiative that reinforced key prevention principles already embedded in practice. The Respiratory Infection Prevention Task Force was established to offer nurses and respiratory therapists hands‑on, bedside‑focused guidance through visual reminders, unit communication and real time teaching. The focus remained on hand hygiene, sterile intubation technique, oral care, head of bed elevation and thoughtful ventilator circuit management. Ongoing feedback and peer support helped teams stay aligned across shifts without disrupting patient care.
The results reflected the power of that collective approach. Rates of tracheitis and ventilator associated pneumonia among intubated neonates decreased by 12% in the nine months following the intervention, and ultimately to zero in the first year. Meanwhile, staff confidence increased, and practice variation narrowed.
Renner’s work highlights a familiar truth in neonatal nursing excellence: Meaningful improvement often comes from reaffirming what teams already do well and supporting them to do it consistently. By strengthening foundational prevention practices, her project enhances NICU patient safety, supports compassionate, high-quality care for the smallest patients and offers reassurance to families who entrust their infants to the NICU team.
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