281. Systematic Review on Impact of Use of Disinfectant Caps Protectors for Intravenous Access Ports on Central Line-Associated Bloodstream Infections (CLABSI)
Session: Poster Abstract Session: HAI: Device Associated Infections
Thursday, October 8, 2015
Room: Poster Hall
Posters
  • IDweek2015_Poster_50556.pdf (1.5 MB)
  • Background:

    Central Line Associated Bloodstream Infections (CLABSIs) result in increased length of stay (LOS) in hospitals, severe illness, and often death. CLABSI prevention methods involve a bundle of interventions that include disinfection of central line access ports. This systematic review was performed to evaluate the effects of alcohol impregnated cap protectors to prevent CLABSI in the inpatient population by passively disinfecting the access port of central venous lines.

    Methods:

    We conducted a systematic review according to the MOOSE guidelines using MEDLINE, EMBASE, CINAHL, Scopus and the Cochrane Database of Systematic Reviews databases without any language or other limits.  One reviewer conducted all the searches according to the inclusion criteria and two authors independently screened the studies for eligibility by reading full text articles; discrepancies were resolved by discussion. Two authors independently abstracted data, assessed study quality and disagreements were resolved by consensus.

    Results:

    Nine quasi-experimental studies were included. All studies accessed CLABSI rates pre and post implementation of disinfectant caps. Following the Down and Brown's checklist to measure study quality, we concluded the quality of the studies to be fair and high. All studies reported reduction of CLABSI rates after the intervention (30-87%). One study reported decrease of 68 days on LOS. Seven studies described monitoring of compliance in utilization of port protector caps. One study found a reduction 2.3% on blood culture contamination percentage.

    Conclusion:

    When comparing the protector caps with scrubbing the hub, the caps demonstrated to be more efficient.  Catheter hub decontamination requires a thorough scrub and compliance is difficult to measure; by utilizing protectors caps compliance is more accurate and a significant reduction can be seen in the burden of CLABSIs in healthcare facilities. The use of alcohol impregnated port protector's caps is associated with reduction of CLABSI rates.

    Author 

    Rate Pre

    Rate Post

    CLABSI Reduction %

    Alasmeri 2012

    5.3

    3.7

    30

    DeVries 2014

    0.07

    0.04

    49

    Doherty2011

    2.1

    0.7

    67

    Merrill 2014

    1.5

    0.9

    40

    Ramirez 2012

    1.9

    0.5

    74

    Shelly 2014

    1.5

    0.5

    67

    Stango 2014

    1.5

    0.8

    47

    Sweet 2012

    2.3

    0.3

    87

    Wright 2013

    1.4

    0.7

    49

    Adriana Jimenez, MPH, MLS (ASCP), CIC., Department of Infection Prevention and Control., Jackson Memorial Hospital, Miami, FL; Department of Epidemiology, Robert Stempel College of Public Health & Social Work, Florida International University., Miami, FL, Anne Barrera, MPH, BSCS., Florida Department of Health in Miami-Dade County, Miami, FL; Department of Epidemiology., Robert Stempel College of Public Health & Social Work, Florida International University. Miami, FL, Miami, FL and Purnima Madhivanan, MD, MPH, PhD., Department of Epidemiology,, Robert Stempel College of Public Health & Social Work, Florida International University. Miami, FL, Miami, FL

    Disclosures:

    A. Jimenez, None

    A. Barrera, None

    P. Madhivanan, None

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 7th with the exception of research findings presented at the IDWeek press conferences.