A fall in bloodstream infections followed a change to 2% chlorhexidine in 70% isopropanol for catheter connection antisepsis: A pediatric single center before/after study on a hemopoietic stem cell transplant ward

Soothill, J. F.; Bravery, Karen; Ho, Anne; Macqueen, Susan; Collins, Jane; Lock, Paul

doi:10.1016/j.ajic.2009.03.014

Cited by 66 publications

(39 citation statements)

References 16 publications

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“…Alcoholic chlorhexidine performed consistently well or better than other disinfection agents in multiple studies [21,24,131,168,172,179,182]. In the research by Hong et al, a 5 second scrub with alcoholic chlorhexidine fully disinfected NC surfaces treated with Pseudomonas Aeruginosa [179].…”

Section: Disinfection Practicesmentioning

confidence: 99%

“…Recommendations from both the Centers for Disease Control and the Infusion Nurses Society state clinician should minimize contamination risk by disinfection the access ports of the add-on device using friction with an appropriate disinfectant (70% alcohol, chlorhexidine, povidone iodine, and iodophors) prior to any access [8,11,24,167,168]. The 70% isopropyl alcohol wipe is most commonly used to disinfect the access surface of NC and has been proven effective or ineffective at disinfection times from 5 seconds to 60 seconds [14, 19, 24-27, 131, 151, 169-177].…”

Section: Disinfection Practicesmentioning

confidence: 99%

“…The major biocide effect of alcohol occurs while wet and immediately after drying, allowing for dehydration of bacterial cells, whereas alcoholic chlorhexidine is most effective during the drying process, where it enters the cell to cause destruction providing ongoing antimicrobial effect [150,172]. The disinfecting action of chlorhexidine in combination with alcohol, allowing for both immediate and sustained action; has proven to be more effective than either agent alone [21,131,168,172,176,[178][179][180]. Faster drying time with alcohol makes it superior to other disinfection agents and provides an advantage to chlorhexidine when used in combination.…”

Section: Disinfection Practicesmentioning

confidence: 99%

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Disinfection of Needleless Connector Hubs: Clinical Evidence Systematic Review

Moureau¹

2015

Journal of the Association for Vascular Access

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Background. Needleless connectors (NC) are used on virtually all intravascular devices, providing an easy access point for infusion connection. Colonization of NC is considered the cause of 50% of postinsertion catheter-related infections. Breaks in aseptic technique, from failure to disinfect, result in contamination and subsequent biofilm formation within NC and catheters increasing the potential for infection of central and peripheral catheters. Methods. This systematic review evaluated 140 studies and 34 abstracts on NC disinfection practices, the impact of hub contamination on infection, and measures of education and compliance. Results. The greatest risk for contamination of the catheter after insertion is the NC with 33-45% contaminated, and compliance with disinfection as low as 10%. The optimal technique or disinfection time has not been identified, although scrubbing with 70% alcohol for 5-60 seconds is recommended. Studies have reported statistically significant results in infection reduction when passive alcohol disinfection caps are used (48-86% reduction). Clinical Implications. It is critical for healthcare facilities and clinicians to take responsibility for compliance with basic principles of asepsis compliance, to involve frontline staff in strategies, to facilitate education that promotes understanding of the consequences of failure, and to comply with the standard of care for hub disinfection.

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Section: Disinfection Practicesmentioning

confidence: 99%

Section: Disinfection Practicesmentioning

confidence: 99%

Section: Disinfection Practicesmentioning

confidence: 99%

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Disinfection of Needleless Connector Hubs: Clinical Evidence Systematic Review

Moureau¹

2015

Journal of the Association for Vascular Access

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“…In recent years, injection through stopcock injection ports has been identified as a potential portal of entry for microorganisms. In general closed catheter systems, used with the appropriate disinfection, have been associated with fewer catheter-related blood stream infections (Casey et al, 2007;O'Grady et al, 2011;Niel-Weise et al, 2006;Soothill et al, 2009). However, Esteve et al (2007) claim that closed catheter systems do not reduce infection rates.…”

Section: Introductionmentioning

confidence: 99%

Introduction of a non-ported peripheral intravenous catheter with multi-use blood control septum offers improvements in the overall efficiency of the procedure and is clinically well accepted

Cooper

Whitfield

Newton

et al. 2016

IJHTM

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Financial challenges that the National Health Service (NHS), England, faces may jeopardise its future. This study evaluated the direct cost of using two different safety peripheral intravenous cannulae (SPIVC) with and without a blood control septum, including the cost of device and clinician time. Observation of 103 cannulations demonstrated a 54 second (29%) time reduction per cannulation with the non-ported SPIVC with multi-use blood control septum (Introcan Safety® 3 B Braun), compared to the standard ported 178 D.M. Cooper et al.SPIVC (Vasofix® Safety B Braun) (P < 0.05). The direct cost analysis, including clinician time, demonstrated that the introduction of SPIVC with multi-use blood control septum could offer time efficiency savings equivalent to a reduction in average cannulation costs by 25%. 82% of users perceived the insertion of SPIVC with multi-use blood control septum to be easy to use; 82% would choose to use it in clinical practice.

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“…It has been shown that external disinfection of the devices with chlorhexidine/alcohol, rather than alcohol alone, can reduce IVC colonization. 47,54 In addition, the time spent on applying the disinfectant is important. Results from one study suggest that wiping the connector with 70% isopropyl alcohol for 3-5 seconds did not adequately disinfect the septal surface.…”

mentioning

confidence: 99%

Reducing the risk of infection associated with vascular access devices through nanotechnology: a perspective

Zhang¹,

Keogh²,

Rickard³

2013

IJN

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Intravascular catheter-related infections are still a major problem in health care and are associated with significant morbidity, mortality, and additional cost. The formation of microbial biofilm on catheters makes these infections particularly complicated, as microbial cells that detach from the biofilm can lead to infection, and because these microorganisms are highly resistant to many antimicrobial agents; thus, catheter removal is often required to successfully treat infection. To reduce the risks of catheter-related infections, many strategies have been applied, such as improvements in aseptic insertion and post-insertion care practices, implantation techniques, and antibiotic coated or impregnated materials. However, despite significant advances in using these methods, it has not been possible to completely eradicate biofilm infections. Currently, nanotechnology approaches seem to be among the most promising for preventing biofilm formation and resultant catheter-related bloodstream infection (especially with multi-resistant bacterial strains). In this review, current knowledge about catheter technology and design, the mechanisms of catheter-related bloodstream infection, and the insertion and care practices performed by medical staff, are discussed, along with novel, achievable approaches to infection prevention, based on nanotechnology.

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A fall in bloodstream infections followed a change to 2% chlorhexidine in 70% isopropanol for catheter connection antisepsis: A pediatric single center before/after study on a hemopoietic stem cell transplant ward

Cited by 66 publications

References 16 publications

Disinfection of Needleless Connector Hubs: Clinical Evidence Systematic Review

Disinfection of Needleless Connector Hubs: Clinical Evidence Systematic Review

Introduction of a non-ported peripheral intravenous catheter with multi-use blood control septum offers improvements in the overall efficiency of the procedure and is clinically well accepted

Reducing the risk of infection associated with vascular access devices through nanotechnology: a perspective

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