Reducing infection rate among the neonates born at Remera Rukoma Hospital: a report of quality improvement project

INTRODUCTION: Neonatal infection, a leading cause of mortality in lower and middle-income countries, was increasing at Remera Rukoma District Hospital in Rwanda, necessitating the identification of the contributing factors and urgent intervention. Therefore, this study aimed to reduce the neonatal infection rate among neonates born at Remera Rukoma Hospital from 18.53% to 10% within 6 months (from January to June 2024). METHODS: From January to June 2024, a multidisciplinary team used a Fishbone diagram for root cause analysis to identify factors in healthcare practices, equipment, hospital environment, and patient domains that were contributing to the increased incidence of neonatal infection in the neonatal ward of Remera Rukoma Hospital. Interventions were implemented and monitored through monthly Plan-Do-Study-Act cycles. RESULTS: Neonatal infection rates decreased from 22.9% in January to 13% in June 2024. While short of the 10% target, this significant improvement resulted from systematic approaches, including regular and targeted staff training and enhanced infection control measures. CONCLUSION: The quality improvement project demonstrated the effectiveness of a structured, data-driven approach in reducing neonatal infection rates. Key lessons include the role of utilizing comprehensive root cause analysis to learn more about the interconnected elements of disease or health issues, continuous staff engagement