* Catheter-related bloodstream infections (CRBSI) are the most common hospital acquired illness. *...
17
THE PURPOSE OF THIS STUDY IS TO DECREASE INFECTION RATES BY EXAMINING THE EFFICACY OF DISINFECTION CAPS VERSUS THE STANDARD SCRUBBING METHOD WHEN UTILIZING A CENTRAL LINE. * Catheter-related bloodstream infections (CRBSI) are the most common hospital acquired illness. * 62,000 people die eac year from a central line infection. (World Health Organization, 201 * 250,000 bloodstream infections occur annually within the hospital setting.
* Catheter-related bloodstream infections (CRBSI) are the most common hospital acquired illness. * 62,000 people die each year from a central line infection
* Catheter-related bloodstream infections (CRBSI) are the most
common hospital acquired illness. * 62,000 people die each year
from a central line infection. (World Health Organization, 2014) *
250,000 bloodstream infections occur annually within the hospital
setting.
Slide 3
Search Words: central line, disinfection cap, decontamination,
infection, and prevention. Search results: Both search engines
provided the best results when using central line infection +
disinfection caps. CINAHL resulted in 138 articles, whereas Pubmed
only listed 5. Search Engines: CINAHL and Pubmed
Slide 4
Two articles were reviewed from the American Journal of
Infection Control (AJIC). The first article involved a
multi-facility study which tested the use of disinfection caps
against the standard scrubbing method (Wright et al., 2013). The
second article was a two year study in which results were compared
from utilizing the standard scrubbing method for the first year,
and utilizing the disinfection caps the following year (Wawrzyniak
et al., 2014).
Slide 5
PICO QUESTION: In patients with central lines, would the use of
alcohol-infused disinfection caps, as compared to scrubbing the hub
with alcohol, reduce catheter-associated infections? The two
articles each involve a study specifically focused on the use of
disinfection caps for central lines. They both compare this
approach with the previously accepted standard scrubbing method.
These experiments are ideal for gathering information on the
proposed PICO question. (Wawrzyniak et al., 2014; Wright et al.,
2014)
Slide 6
The concept- Central line infection rates should fall with
improved line disinfection. The theory- Alcohol infused
disinfection caps will provide better infection control.
Slide 7
Article 1: * Multi-facility, Quasi-experimental * Three phases:
1. Standard scrub 2. Disinfection cap 3. Back to standard scrub
Who? Adult inpatients with at least five days of admission What?
1.5mL of blood drawn from central line When? Twice a week Why?
Tested for bacterial growth Article 2: One facility, 2 year pre and
post observational study Who? All patients in the facility,
including pediatrics What? Infection rates When? One year of
standard scrub method, and one year of utilizing disinfection caps
Why? To determine which method best decreases infections rates
(Wawrzyniak et al., 2014) (Wright et al., 2014 )
Slide 8
Article 1: * The use of disinfection caps effectively decreased
infection rates in each facility. * If an infection did occur, it
included less organisms as compared to the standard scrubbing
method. * When returning to the standard scrubbing method,
infection rates increased. * Each facility has now implemented
these caps as part of their standard of practice. Article 2: *
Standard scrubbing method: 59 infections * Disinfection caps: 23
infections * 68% overall decrease in infection rate. (Wawrzyniak et
al., 2014) (Wright et al., 2014)
Slide 9
* Informed consent * Confidentiality * Choosing who receives
treatment (justice) * Proper review from the Institutional Review
Board (IRB) (Blessing & Forister, 2013)
Slide 10
Both studies provided clear and concrete methods and results.
The first study used multiple facilities, which helps to make the
evidence more credible. The second study used multiple types of
patients and diagnoses, along with a long two year span of
collecting information. (Wawrzyniak et al., 2014; Wright et al.,
2014)
Slide 11
Both articles were published in the AJIC, a major resource for
epidemiology, disease prevention, and infectious diseases. AJIC has
a large editorial board with over fifty health professionals. The
board is comprised of pharmacists, registered nurses, and
physicians. The articles are peer-reviewed. The authors all
practice medicine with varying degrees such as MDs and RNs with BSN
and/or MSN. (Wawrzyniak et al., 2014; Wright et al., 2014; AJIC,
2014)
Slide 12
The evidence from all of the studies show an improvement in
infection rates when the alcohol-infused disinfection caps were
used. Multiple facilities have implemented these caps into their
standard of practice due to the level of evidence found in these
articles and other previous studies. (Wawrzyniak et al., 2014;
Wright et al., 2014)
Slide 13
The findings from the disinfection caps have shown nothing but
positive outcomes to patient care, which makes them relevant to the
field. They have the potential to save multiple lives. Once
facilities choose to implement them, staff education would be
needed. The caps have a possibility of being considered an overall
standard of professional practice.
Slide 14
Findings indicate a strong potential for change in the standard
of care. Infection rates in both studies have substantially
declined, increasing patient safety. The caps are simple, quick,
and cost effective. The major barrier would be for staff to
remember to include them into their routine.
Slide 15
In patients with disinfection caps on their central lines,
would leaving the cap on for a maximum of four days, as compared to
changing it on a daily basis, decrease the rate of infection? In
patients with central lines, would scrubbing the hub with betadine,
as compared to rubbing alcohol, decrease the rate of
infection?
Slide 16
Alcohol-infused disinfection caps have reduced the rates of
infection in patients with a central line. Not only does this
prevent unnecessary hospital stays and medical bills, but it can
spare the lives of many people who experience these types of
infections. (Wawrzyniak et al., 2014; Wright et al., 2014)
Slide 17
American Journal of Infection Control (AJIC). (2014). Current
issue. Retrieved from http://www.ajicjournal.org/ Blessing, J.D.
& Forister, J.G. (2013). Introduction to research and medical
literature for health professionals. (3 rd ed.). Burlington, MA:
Jones & Bartlett Learning, LLC. Wawrzyniak, M.M, Parada, J.,
Lewis, K., Mallek, A., Suarez-Ponce, S., Trulis, E., & Tomich,
A. (2014). Significant improvement in CLABSI rates following
routine use of disinfection caps on all access ports: Better
safety, better resource utilization. American Journal of Infection
Control, 42, S15-6. doi: 10.1016/j.ajic.2014.03.055
Slide 18
World Health Organization (WHO). (2014). Preventing bloodstream
infections from central line venous catheters. Retrieved from
http://www.who.int/patientsafety/impleme ntation/bsi/en/ Wright,
M., Tropp, J., Schora, D.M., Dillon- Grant, M., Peterson, K.,
Boehm, S., & Peterson, L.R. (2013). Continuous passive
disinfection of catheter hubs prevents contamination and
bloodstream infection. American Journal of Infection Control,
41(1), 33-38. doi: 10.1016/j.ajic.2012.05.030