| Primary Author: | Katreena Collette Merrill, RN, PhD |
| Co-Principal Investigators/Collaborators: | Sharon Sumner, RN, IP, Lorraine Linford, Rn, Aubree Atkins,Rn |
| Organization | Bringham Young University |
Abstract
Purpose
The purpose of this research study was to explore nurses compliance with IV access port disinfection practices.
Background
About 250,000 central line associated bloodstream infections (CLABSI) occur annually, increasing mortality and costing between $25-55,000 per incident. To prevent infection in patients with IV access devices the CDC recommends disinfecting injection ports (2011). However, disinfection prior to port entry is insufficient protection against microbial contamination (Menhay & Maki, 2006). Additional safeguards such as a disinfectant cap may be needed to lower the risk of CLABSI (Oto, Imanaka, Konno, Nakataki, & Nishimura, 2011).
Materials & Methods
In this descriptive study of nurses working on inpatient units at a tertiary care hospital, direct care nurses were sent an e-mail link to an electronic survey (n = 2000). They reported disinfection practices for peripheral and central IV access ports, intermittant IV tubing and reasons for non-compliance. The results were used as a baseline for a study the effect of a disinfectant cap on CLABSI.
Results
The response rate was 18% (n =360). Most nurses (76.4%) reported disinfecting peripheral IV access ports every time, however, 34% reported being compliant to the evidence based procedure (15 seconds of vigorous scrubbing), resulting in a 50% compliance rate. A higher rate of nurses reported disinfecting central line access ports every time (93.8%). However, 35% did not use the appropriate procedure, resulting in 60% compliance rate. Common reasons for non-compliance included; emergent situation (39.5%), time constraints (9.5%) and not necessary (6.8%). For intermittent IV sets, 69.2% were compliant with hospital infection control procedures.
Conclusion
CLABSI remains an important preventable event. One current evidence based strategy to decrease CLABSI is disinfection of IV ports. Many nurses report compliance to routine disinfection of IV access ports, however, fewer nurses performed the process correctly. In addition, the evidence-based literature suggests that manual disinfection may not be adequate to prevent microbial contamination. Further research into technologies such as disinfectant hubs is needed.
Bibliography
Centers for Disease Control and Prevention. (2011). Guidelines for prevention of intravascular catheter-related infections. Retrieved from http://www.cdc.gov/hicpac/pdf/guidelines/bsi-guidelines-2011.pdf
Mennay, S.Z., & Maki, D.B. (2006). Disinfection of needless catheter connectors and access ports with alcohol may not prevent microbial entry: The promise of a novel antiseptic-barrier cap. Infection Control and Hospital Epidemiology, 17(1), 23-27.
Oto, J., Imanaka, H., Konno, M., Nakataki, E., & Nishimura, M. (2011). A prospective clinical trial on prevention of catheter contamination using the hub protection cap for needleless injection device. American Journal of Infection Control. 39(4), 309-313.
© Improvement Science Research Network, 2012
The ISRN published this as received and with permission from the author(s).