Strategies for the successful implementation of disinfecting port protectors to reduce CLABSI in a large tertiary care teaching hospital

Beeler, Cole; Kerley, K. Denise; Davis, Carmen; Hazen, Dana; Snyderman, William; Lyons, Kathleen Doyle; Sadowski, Josh; Sweeney, Jennifer; Dbeibo, Lana; Kelley, Kristen; Webb, Douglas

doi:10.1016/j.ajic.2019.05.016

Cited by 4 publications

(2 citation statements)

References 12 publications

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“…This reduction resulted in a total cost savings of $1,636,792 due to 27 fewer CLABSIs, after considering the added cost of the port protectors. 10 Furthermore, meta-analyses have consistently shown that disinfecting caps can reduce CLABSI rates by 41-57% compared to scrubbing the hub and generate median cost savings of $21,890 per CLABSI. [11][12][13][14] Additionally, studies have indicated that disinfecting caps can enhance the effectiveness of CLABSI prevention bundles.…”

Section: Introductionmentioning

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: Introductionmentioning

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

“…Over the past 7 years, the guide has been requested from our organization’s website over 5000 times from 51 countries and all US states, cited over 100 times, and translated into several languages. The framework has been cited as supporting EBP change and organizational EBP programming, and as supporting the need for research or affirming the phased, yet iterative nature of implementation and the need to address organizational support [ 41 – 47 ]. Strategies have been operationalized with definitions, actionable procedures, and examples, to promote effective use and improve implementation outcomes in a monograph entitled Evidence-Based Practice in Action [ 33 ].…”

Section: Introductionmentioning

confidence: 99%

Iowa Implementation for Sustainability Framework

et al. 2022

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Background An application-oriented implementation framework designed for clinicians and based on the Diffusion of Innovations theory included 81 implementation strategies with suggested timing for use within four implementation phases. The purpose of this research was to evaluate and strengthen the framework for clinician use and propose its usefulness in implementation research. Methods A multi-step, iterative approach guided framework revisions. Individuals requesting the use of the framework over the previous 7 years were sent an electronic questionnaire. Evaluation captured framework usability, generalizability, accuracy, and implementation phases for each strategy. Next, nurse leaders who use the framework pile sorted strategies for cultural domain analysis. Last, a panel of five EBP/implementation experts used these data and built consensus to strengthen the framework. Results Participants (n = 127/1578; 8% response) were predominately nurses (94%), highly educated (94% Master’s or higher), and from across healthcare (52% hospital/system, 31% academia, and 7% community) in the USA (84%). Most (96%) reported at least some experience using the framework and 88% would use the framework again. A 4-point scale (1 = not/disagree to 4 = very/agree) was used. The framework was deemed useful (92%, rating 3–4), easy to use (72%), intuitive (67%), generalizable (100%), flexible and adaptive (100%), with accurate phases (96%), and accurate targets (100%). Participants (n = 51) identified implementation strategy timing within four phases (Cochran’s Q); 54 of 81 strategies (66.7%, p < 0.05) were significantly linked to a specific phase; of these, 30 (55.6%) matched the original framework. Next, nurse leaders (n = 23) completed a pile sorting activity. Anthropac software was used to analyze the data and visualize it as a domain map and hierarchical clusters with 10 domains. Lastly, experts used these data and implementation science to refine and specify each of the 75 strategies, identifying phase, domain, actors, and function. Strategy usability, timing, and groupings were used to refine the framework. Conclusion The Iowa Implementation for Sustainability Framework offers a typology to guide implementation for evidence-based healthcare. This study specifies 75 implementation strategies within four phases and 10 domains and begins to validate the framework. Standard use of strategy names is foundational to compare and understand when implementation strategies are effective, in what dose, for which topics, by whom, and in what context.

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Preventing catheter-related infections in cancer patients: a review of current strategies

Malek

Raad

2020

Expert Review of Anti-infective Therapy

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Strategies for the successful implementation of disinfecting port protectors to reduce CLABSI in a large tertiary care teaching hospital

Cited by 4 publications

References 12 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

Iowa Implementation for Sustainability Framework

Preventing catheter-related infections in cancer patients: a review of current strategies

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