Adequate Disinfection of a Split-Septum Needleless Intravascular Connector with a 5-Second Alcohol Scrub

Rupp, Mark E.; Yu, Stephanie Dorothy Pui Ming; Huerta, T.; Cavalieri, R. Jennifer; Alter, Roxanne; Fey, Paul D.; Schooneveld, Trevor Van; Anderson, James R.

doi:10.1086/666337

Cited by 40 publications

(28 citation statements)

References 17 publications

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“…It has been suggested that negative-and positive-displacement mechanical needleless IV access devices, because of their complex design, may be susceptible to contamination. [15][16][17][18] In this study, there were significant differences between the needleless IV access devices with regard to microbial ingress following both cleaning schedules. In comparison, in a recent observational study, rates of bloodstream infection were found to remain at zero regardless of whether a neutral-or positive-displacement valve was used.…”

Section: Discussionmentioning

confidence: 99%

An In Vitro Comparison of Microbial Ingress Into 8 Different Needleless IV Access Devices

Casey

Kärpänen

Elliott

2015

Journal of Infusion Nursing

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There are conflicting reports of the effect needleless intravenous access devices have on rates of catheter-related bloodstream infection. The aim of this study was to identify any differences between the rates of microbial ingress into 8 different devices following contamination. Each type of device was subjected to a 7-day clinical simulation that involved repeated microbial contamination of the injection site and decontamination followed by saline flushes. Significant differences in the number of microorganisms associated with each device were detected in the saline eluates. Three positive-displacement mechanical valves were associated with the ingress of significantly fewer microorganisms compared with other devices.

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Section: Discussionmentioning

confidence: 99%

An In Vitro Comparison of Microbial Ingress Into 8 Different Needleless IV Access Devices

Casey

Kärpänen

Elliott

2015

Journal of Infusion Nursing

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“…Apply mechanical friction for no less than 5 seconds to reduce contamination. 121,122 It is unclear whether this duration of disinfection can be generalized to needleless connectors not tested in these studies. a.…”

Section: Lowmentioning

confidence: 98%

Strategies to Prevent Central Line–Associated Bloodstream Infections in Acute Care Hospitals: 2014 Update

Marschall

Mermel

Fakih

et al. 2014

Infect. Control Hosp. Epidemiol.

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428

188

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“…Two additional studies gave conflicting results. Rupp demonstrated 5 second alcohol disinfection was effective; this was in direct contrast with the Smith study where contact time of 10/12/15 seconds was deemed adequate, but 5 and 8 seconds were not as effective to prevent bacterial transfer [170,171]. Simmons and colleagues found 3/10/15 seconds significantly decreased the bacterial load in an in vitro laboratory study, with some level of bacteria remaining during all duration levels tested; disinfection failed to completely eliminate contaminants [13].…”

Section: Disinfection Practicesmentioning

confidence: 81%

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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Adequate Disinfection of a Split-Septum Needleless Intravascular Connector with a 5-Second Alcohol Scrub

Abstract: A 5-second scrub with a 70% isopropyl alcohol pledget yields adequate disinfection of a split-septum intravascular catheter connector valve under clinical and laboratory conditions.

Cited by 40 publications

References 17 publications

An In Vitro Comparison of Microbial Ingress Into 8 Different Needleless IV Access Devices

An In Vitro Comparison of Microbial Ingress Into 8 Different Needleless IV Access Devices

Strategies to Prevent Central Line–Associated Bloodstream Infections in Acute Care Hospitals: 2014 Update

Disinfection of Needleless Connector Hubs: Clinical Evidence Systematic Review

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