Disinfection Cap Makes Critical Difference in Central Line Bundle for Reducing CLABSIs

Lee, Jayne

doi:10.1016/j.ajic.2011.04.124

Cited by 7 publications

(3 citation statements)

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“…25 Similarly, a US hospital observed less than 10% compliance with the disinfection protocol when using the manual method of scrubbing with alcohol. 26 The implementation of passive disinfection caps has shown improved compliance, which reduces the risk of contamination through the intraluminal route and the formation of biofilm that can occur when IV catheter hub disinfection is compromised. In addition to providing superior cleaning options that result in higher reduction rates of microorganisms, disinfecting caps have the potential to free up clinical time by replacing the traditional “active disinfection” method with a “passive” one.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of Disinfecting Caps for Intravenous Access Points in Reducing Central Line-Associated Bloodstream Infections, Clinical Utilization, and Cost of Care During COVID-19

Hou,

Griffin,

Ertmer

et al. 2023

CEOR

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Purpose Intravenous (IV) access point protectors, serving as passive disinfection devices and a cover between line accesses, are available to help reduce the risk of central line-associated bloodstream infections (CLABSIs). This low-maintenance disinfection solution is particularly valuable in situations with excessive workloads. This study examined the effect of a disinfecting cap for an IV access point on CLABSI rates, hospital length of stay, and cost of care in an inpatient setting during the coronavirus disease 2019 (COVID-19) pandemic. Methods The study utilized data from the Premier Healthcare Database, focusing on 200,411 hospitalizations involving central venous catheters between January 2020 and September 2020. Among these cases, 7423 patients received a disinfecting cap, while 192,988 patients did not use any disinfecting caps and followed the standard practice of hub scrubbing. The two cohorts, Disinfecting Cap and No-Disinfecting Cap groups, were compared in terms of CLABSI rates, hospital length of stay (LOS), and hospitalization costs. The analysis accounted for baseline group differences and random clustering effects by employing a 34-variable propensity score and mixed-effect multiple regression, respectively. Results The findings demonstrated a significant 73% decrease in CLABSI rates (p= 0.0013) in the Disinfecting Cap group, with an adjusted CLABSI rate of 0.3% compared to 1.1% in the No-Disinfecting Cap group. Additionally, the Disinfecting Cap group exhibited a 0.5-day reduction in hospital stay (9.2 days versus 9.7 days; p = 0.0169) and cost savings of $6703 ($35,604 versus $42,307; p = 0.0063) per hospital stay compared to the No-Disinfecting Cap group. Conclusion This study provides real-world evidence that implementing a disinfecting cap to protect IV access points effectively reduces the risk of CLABSIs in hospitalized patients compared to standard care, ultimately optimizing the utilization of healthcare resources, particularly in situations where the healthcare system is under significant strain or overloaded.

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Section: Discussionmentioning

confidence: 99%

Effectiveness of Disinfecting Caps for Intravenous Access Points in Reducing Central Line-Associated Bloodstream Infections, Clinical Utilization, and Cost of Care During COVID-19

Hou,

Griffin,

Ertmer

et al. 2023

CEOR

View full text Add to dashboard Cite

show abstract

“…Disinfection of a catheter hub prior to flushing or prior to the administration of medications is required for all aseptic access, yet in the Karchmer study, 31% of clinicians did not even attempt to disinfect, even when under active observation [ 1 , 64 , 88 , 114 ]. In a study by Lee the disinfection compliance by clinicians prior to NC access was measured at only 10% [ 115 ]. This common break in aseptic technique sets the stage for biofilm formation within NC and catheters and increases the potential for delayed infection of both central and peripheral catheters [ 14 , 60 , 68 , 112 , 116 ].…”

Section: Introductionmentioning

confidence: 99%

Disinfection of Needleless Connector Hubs: Clinical Evidence Systematic Review

Moureau

Flynn

2015

Nursing Research and Practice

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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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“…Disinfection of a catheter hub prior to flushing or prior to the administration of medications is required for all aseptic access, yet in the Karchmer study, 31% of clinicians did not even attempt to disinfect, even when under active observation [1,64,88,114]. In a study by Lee the disinfection compliance by clinicians prior to NC access was measured at only 10% [115]. This common break in aseptic technique sets the stage for biofilm formation within NC and catheters and increases the potential for delayed infection of both central and peripheral catheters [14,60,68,112,116].…”

Section: Introductionmentioning

confidence: 99%

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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Disinfection Cap Makes Critical Difference in Central Line Bundle for Reducing CLABSIs

Cited by 7 publications

References 0 publications

Effectiveness of Disinfecting Caps for Intravenous Access Points in Reducing Central Line-Associated Bloodstream Infections, Clinical Utilization, and Cost of Care During COVID-19

Effectiveness of Disinfecting Caps for Intravenous Access Points in Reducing Central Line-Associated Bloodstream Infections, Clinical Utilization, and Cost of Care During COVID-19

Disinfection of Needleless Connector Hubs: Clinical Evidence Systematic Review

Disinfection of Needleless Connector Hubs: Clinical Evidence Systematic Review

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