Alcohol-Impregnated Disinfectant Caps Reduce The Rate Of Central-Line Associated Bloodstream Infections And Nosocomial Bacteremia
Methods: We evaluated the effect of an alcohol disinfection cap on rates of nosocomial bacteremia. The plastic caps fit on the exposed ends of IV needless access devices and contain a pad saturated with 70% isopropyl alcohol for disinfection: we alternated between similar products by two different manufacturers. The caps were placed on all ports of peripheral and central lines when not in use. Four hospital units with higher central line use were chosen for this yearlong intervention (an intensive care unit, a step down unit, and two medical surgical units). Nosocomial bloodstream infections and CLABSI were monitored for these units, along with four units not part of this intervention (to control for changes over time). The year prior to implementation served as comparison. Chi-square was used to test for change in the incidence of infection.
Results: The rate of CLABSI fell from 1.5 per thousand line days (kld) (16 CLABSI / 10 441 line days) to 0.4 per kld (4 / 9 536, P = 0.013). There was no significant change for units not using the caps, 0.6 (4 / 6 871) to 0.4 per kld (3 / 7 790, P = 0.59). The rate of nosocomial BSI also fell significantly, 0.73 per thousand patient days (kpd) (40 BSI / 33 037 patient days) to 0.47 (21 / 36 362), P = 0.005). Rates did not differ significantly between the two different products.
Conclusion: Using alcohol disinfectant caps on all IV access ports significantly reduced the rate of CLABSI and nosocomial bacteremia for a variety of inpatient hospital units.
L. Brown, None
S. Romig, None
A. M. Pettis, None