Major articleImpact 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
Section snippets
Methods
This quality improvement measure was a single-center analysis in the hematology/oncology unit at West Virginia University Hospitals. The study was approved by the Institutional Review Board.
Before implementation, we conducted a retrospective review of the hospital's electronic databases from January 1 through December 31, 2009, for CLABSIs and from July 1 through December 31, 2009, for CBCs. Culture results obtained within 48 hours of admission were excluded, to focus on hospital-acquired
Results
During the year before implementation, 472 patients with CVCs accounted for a total of 911 hospital admissions and 6,851 central line-days. Sixteen CLABSIs were documented during this preintervention period. The 6-month intervention period involved 282 patients, who accounted for a total of 479 hospital admissions and 3,005 central line-days. There were no significant statistical differences in baseline characteristics between the 2 groups (Table 1). The 2 groups also did not differ
Discussion
Health care–associated infections are now more commonly caused by highly resistant organisms, such as MRSA, vancomycin-resistant enterococci, extended-spectrum β-lactamase–producing Enterobacteriaceae and panresistant Acinetobacter species. These resistant organisms can be challenging to treat and are associated with increased mortality and morbidity.13, 14, 15 The paradigm for dealing with health care–associated infections needs to shift from treatment to prevention. Strategies to prevent
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Antiseptic barrier caps to prevent central line-associated bloodstream infections: A systematic review and meta-analysis
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Antiseptic barrier caps in central line-associated bloodstream infections: A systematic review and meta-analysis
2022, European Journal of Internal MedicineCitation Excerpt :The study by Flynn et al. [9] compared the effectiveness of connector decontamination with 70% alcohol wipes, alcoholic chlorhexidine gluconate wipes, or alcohol impregnated caps to prevent CLABSI in ten studies. Five studies [23,28,29,35,36] were analysed in the SRMA reporting that alcohol impregnated caps (RR: 0.43; 95%CI 0.28–0.65) and alcoholic chlorhexidine gluconate wipes (RR: 0.28; 95%CI: 0.20–0.39) were associated with significantly less catheter-associated bloodstream infections than 70% alcohol wipes. Both reviews [9,11] concluded that the cost of antiseptic barrier cap use is surpassed by the costs associated with CLABSI management and allows savings.
A quality improvement study on the reduction of central venous catheter-associated bloodstream infections by use of self-disinfecting venous access caps (STERILE)
2021, American Journal of Infection ControlCitation Excerpt :The incidence rate of CLABSI per 1,000 line-days was 15.28 for the control group and 10.38 for the ABC group. Other studies reported incidence rates that ranged from 1.44 to 4.30 in control groups and 0.33-2.02 in ABC groups.1,3,4,6,12 The vast majority of these studies did not specifically report results from high-risk groups such as hematological patients.
Effect of the use of an antiseptic barrier cap on the rates of central line–associated bloodstream infections in neonatal and pediatric intensive care
2020, American Journal of Infection ControlCitation Excerpt :It is less likely that the somewhat lower adherence to the use of the antiseptic barrier cap in the PICU has resulted in a moderate effect on CLABSI reduction of 18.6%. Still, the adherence rate in the PICU was higher than that in other studies, which have reported rates ranging from 63%-85%.19,20 Besides studying the effect of the use of the antiseptic barrier cap, we studied implementation outcomes (feasibility and fidelity) to understand the use and adherence of the intervention in daily practice.
New Directions in Ensuring Catheter Safety
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Conflict of interest: None to report.