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Central line-associated bloodstream infections (CLABSI) dropped by 52% when an alcohol-impregnated disinfection cap was used instead of standard scrubbing protocol, according to a new study published in the January issue of the American Journal of Infection Control, the official publication of the Association for Professionals in Infection Control and Epidemiology.
A team of researchers from NorthShore University HealthSystem conducted a study of adult patients in order to determine the efficacy of 70% alcohol-impregnated disinfection caps over the standard cleaning protocol, which involves scrubbing the catheter hub with an alcohol disinfectant wipe prior to accessing the lines. In a three-phased study, contamination rates among 799 patients sampled from three hospitals declined from a baseline of 12.7% using the standard cleaning protocol, to 5.5% when the disinfection cap was used, and increased back to 12% when the intervention was removed and standard protocol was reinstated. Infection rates at four hospitals declined from a baseline of 1.43 per 1,000 line days to 0.69 during the intervention, and returned to 1.31 per 1,000 line days when the intervention was suspended.
The researchers estimated that system-wide implementation of the disinfecting caps would prevent 21 CLABSIs and four deaths each year.
“Catheter hub decontamination requires a thorough scrub, and compliance varies,” state the authors. “The approach of using a continuously applied alcohol-impregnated sponge as a cap on the hub for a standard approach to catheter care may eliminate the problem of teaching healthcare providers one additional disinfection process they need to use as part of their busy patient care schedule.”