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Use of disinfection cap helps reduce CLABSI rate

Thursday January 3, 2013
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Central line-associated bloodstream infections dropped by 52% when an alcohol-impregnated disinfection cap was used instead of a standard scrubbing protocol, according to a study.

A team of researchers from NorthShore University HealthSystem in Illinois conducted a study of adult patients 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 the 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," the authors wrote. "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."

The study appears in the January issue of the American Journal of Infection Control, the official publication of the Association for Professionals in Infection Control and Epidemiology, and is available at www.ajicjournal.org/article/S0196-6553%2812%2901023-1/fulltext.


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