Impact of alcohol-impregnated port protectors and needleless neutral pressure connectors on central line–associated bloodstream infections and contamination of blood cultures in an inpatient oncology unit

Sweet, Michael; Cumpston, Aaron; Briggs, Frank; Craig, Michael; Hamadani, Mehdi

doi:10.1016/j.ajic.2012.01.025

Cited by 71 publications

(51 citation statements)

References 16 publications

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“…7,24 Unlike our study, in which no significant decrease in the HA-CLABSI rate among general oncology patients was observed, Sweet et al 24 found a decrease in the CLABSI rate from 2.3 to 0.3 infections per 1,000 catheter days after introduction of CVC disinfection caps. They reported a simultaneous intervention during the study period to replace the connector previously in use with a neutral-pressure device to accommodate the size of the disinfection cap.…”

Section: Discussioncontrasting

confidence: 77%

Use of Disinfection Cap to Reduce Central-Line–Associated Bloodstream Infection and Blood Culture Contamination Among Hematology–Oncology Patients

Kamboj

Blair

Bell

et al. 2015

Infect. Control Hosp. Epidemiol.

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OBJECTIVE In this study, we examined the impact of routine use of a passive disinfection cap for catheter hub decontamination in hematology–oncology patients. SETTING A tertiary care cancer center in New York City METHODS In this multiphase prospective study, we used 2 preintervention phases (P1 and P2) to establish surveillance and baseline rates followed by sequential introduction of disinfection caps on high-risk units (HRUs: hematologic malignancy wards, hematopoietic stem cell transplant units and intensive care units) (P3) and general oncology units (P4). Unit-specific and hospital-wide hospital-acquired central-line–associated bloodstream infection (HA-CLABSI) rates and blood culture contamination (BCC) with coagulase negative staphylococci (CONS) were measured. RESULTS Implementation of a passive disinfection cap resulted in a 34% decrease in hospital-wide HA-CLABSI rates (combined P1 and P2 baseline rate of 2.66–1.75 per 1,000 catheter days at the end of the study period). This reduction occurred only among high-risk patients and not among general oncology patients. In addition, the use of the passive disinfection cap resulted in decreases of 63% (HRUs) and 51% (general oncology units) in blood culture contamination, with an estimated reduction of 242 BCCs with CONS. The reductions in HA-CLABSI and BCC correspond to an estimated annual savings of $3.2 million in direct medical costs. CONCLUSION Routine use of disinfection caps is associated with decreased HA-CLABSI rates among high-risk hematology oncology patients and a reduction in blood culture contamination among all oncology patients.

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Section: Discussioncontrasting

confidence: 77%

Use of Disinfection Cap to Reduce Central-Line–Associated Bloodstream Infection and Blood Culture Contamination Among Hematology–Oncology Patients

Kamboj

Blair

Bell

et al. 2015

Infect. Control Hosp. Epidemiol.

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“…1 There is conflicting opinion regarding whether a 5-second alcohol scrub of needleless IV access device ports is sufficient. 20 There are also limited published data on the efficacy of silver impregnated/coated needleless IV access devices. Indeed, overall there was no significant difference between the median number of CFU recovered following a 5-and 15-second decontamination regimen.…”

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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“…In a retrospective study investigating the introduction of disinfection cap, CLABSI rates dropped from 1.682/1000 catheter days to 0.6461/1000 catheter days after implementing disinfection caps, achieving statistical significance[41]. In an observational study in an oncology unit, a total of 3,005 catheter-days and 1 CLABSI (0.3 infections/1,000 catheter-days) were documented during an intervention period where alcohol-impregnated port-protectors were introduced, compared with 6,851 catheter-days and 16 CLABSIs (2.3 infections/1,000 catheter-days) during the control period (RR, 0.14; 95% CI, 0.02–1.07; p = .03)[42]. As an effective antiseptic method that does not rely on active human intervention, disinfection caps are an attractive way to complement a comprehensive CLABSI reduction strategy.…”

Section: Closed Icu Vs Open Icumentioning

confidence: 99%

Prevention of Central Line–Associated Bloodstream Infections

Bell

O’Grady

2017

Infectious Disease Clinics of North America

180

105

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Central venous catheters (CVC) are commonly used in critically ill patients and offer several advantages to peripheral intravenous access. However, indwelling CVCs have the potential to lead to blood stream infections, with the risk increasing with an array of characteristics such as catheter choice, catheter location, insertion technique and catheter maintenance. Evidence-based guidelines have led to a significant reduction in the incidence of blood stream infections associated with CVCs. The combination of guideline implementation combined with newer technologies has the potential to further reduce morbidity and mortality from infections related to CVCs.

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Impact of alcohol-impregnated port protectors and needleless neutral pressure connectors on central line–associated bloodstream infections and contamination of blood cultures in an inpatient oncology unit

Cited by 71 publications

References 16 publications

Use of Disinfection Cap to Reduce Central-Line–Associated Bloodstream Infection and Blood Culture Contamination Among Hematology–Oncology Patients

Use of Disinfection Cap to Reduce Central-Line–Associated Bloodstream Infection and Blood Culture Contamination Among Hematology–Oncology Patients

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

Prevention of Central Line–Associated Bloodstream Infections

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