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Bloodstream infections reduced through better central line care at three hospitals
Date:6/5/2014

A gap analysis, utilizing observational audits, identified inadequate catheter maintenance; specifically, employees were not consistently scrubbing the hub with alcohol for the required 15 seconds before accessing the line. Keeping catheter connector hubs and injection ports disinfected reduces the risk of bloodstream infections.

The task force, including members of the infection prevention department, as well as hospital employees, tried a range of evidence-based strategies to improve line maintenance, but did not see improvement in CLABSI rates until alcohol-impregnated port protectors, which had already been used successfully in the hospital's neonatal intensive care unit (NICU), were introduced.

In November 2012, infection preventionists received approval from hospital administration to use the disinfecting caps on every patient, for every port, on every unit. In 10 months, CLABSI rates decreased by 68 percent. By adding a simple device to other evidence-based measures, Texas Health Dallas prevented 17 CLABSIs during the first 10 months for a total cost savings of $410,000. Additionally, by eliminating the need to scrub the hub, they calculated an annual time savings of 144 nurse hours.

"We did this in a very systematic fashion," said Barbara Danielson, RN, BSN, CIC, study author and infection prevention manager at Texas Health Dallas. "We involved a team and went through the necessary steps to show that this was the intervention that we needed."

To maintain compliance with use of the alcohol-impregnated port protectors, the infection prevention team educated nurse managers and front-line providers, conducted weekly audits, and made sure the port protectors were readily available at every point-of-use. It took five months to reach their goal of 85 percent of patients having 100 percent of their connector hubs and ports covered.

"The alcohol-impregnated port protectors represent one way to protect the line and keep
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Contact: Liz Garman
egarman@apic.org
202-454-2604
Association for Professionals in Infection Control
Source:Eurekalert

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