BackgroundPremature and sick neonates in the neonatal intensive care unit (NICU) are in need of central lines placing them at high risk of contracting a central line-associated bloodstream infection (CLABSI). CLABSI extends length of stay to 10–14 days post negative cultures and increases morbidity, use of multiple antibiotics, mortality and hospital cost. To reduce CLABSI rate at the American University of Beirut Medical Center NICU, the National Collaborative Perinatal Neonatal Network developed a quality improvement project to reduce CLABSI rate by 50% over a 1-year period and to sustain reduced CLABSI rate.MethodsCentral line insertion and maintenance bundles were implemented for all infants admitted to the NICU necessitating central lines placement. Bundles included hand washing, wearing protective material and sterile drapes during central lines insertion and maintenance.ResultsCLABSI rate decreased by 76% from 4.82 (6 infections; 1244 catheter days) to 1.09 (2 infection; 1830 catheter days) per 1000 CL days after 1 year. Following the bundles’ success in reducing CLABSI rate, they were incorporated permanently to NICU standard procedure and bundle checklists were added to the medical sheets. CLABSI rate was maintained at 1.15 per 1000 CL days during the second year. It then decreased to 0.66 per 1000 CL days in the third year before reaching zero in the fourth year. In total, zero CLABSI rate was sustained for 23 consecutive months.ConclusionReducing CLABSI rate is necessary to improving newborn quality of care and outcome. Our bundles were successful in drastically reducing and sustaining a low CLABSI rate. It was even successful in achieving a zero CLABSI unit for 2 years.

Background When COVID-19 first appeared in December 2019, it quickly spread to become a pandemic. It is a member of the coronavirus family of viruses, which has previously been responsible for a few attacks. The development of preventative and management methods during the early phases of this pandemic was greatly aided by information derived from earlier studies on the etiology and epidemiology of other viruses belonging to this family. Additionally, the general Syrian population already has a number of comorbidities as a result of a poor healthcare system and difficult economic situations, which might have a negative impact on the treatment of COVID-19-infected individuals. Methods A retrospective study was conducted at Damascus Hospital to assess the most important clinical symptoms and prognostic markers for COVID-19 patients between the middle and end of 2021. The chi-square test was employed to investigate the association between illness outcome and research factors. The threshold for statistical significance was set at P 0.05. Results The gender split among the 127 COVID-19 patients was 54% men and 46% women. 31% of patients were between the ages of 61 and 70, making up the majority. Diabetes and high blood pressure were present in 41% and 60% of the patients, respectively. Dyspnea, tiredness, coughing, and severe heat were all experienced by 86% of the patients. Acute respiratory failure caused 64% of deaths, whereas 23% of deaths were due to cardiac and respiratory arrest. A statistically significant correlation between COVID-19 results and clinical symptoms and laboratory results was found (P 0.05). Conclusion The results of the study indicated that the main cause of death in Covid 19 is either due to acute respiratory failure or to cardiac and respiratory arrest. Patients with comorbidities were more likely to develop disease, and some laboratory tests could predict disease progression and death: creatinine, urea, and hepatic parameters could be used as indicators of disease progression.