Study Finds Use of Disinfection Cap Is Associated with Fewer Bloodstream Infections

Newswise — EVANSTON, IL – Jan. 3, 2013 – Patients at NorthShore University HealthSystem (NorthShore) are now better protected against potentially deadly infections, according to a newly published study. The research found that use of a disinfection cap on catheters and tubing reduced infection of central intravenous catheters by more than half. The study, which involved all four hospitals in the NorthShore system, was published in the January 2013 issue of the prestigious American Journal of Infection Control.

Because of the study results, use of the disinfection cap has been adopted as a standard of practice at NorthShore for all central IV catheters.

“Most hospitals have a hard time assuring proper disinfection of IV needleless connectors,” said Marc-Oliver Wright MT (ASCP), MS, CIC, the study’s lead author and Corporate Director of Infection Control for NorthShore. “This is a real concern because contaminated connectors are a major source of central line associated bloodstream infections, or CLABSIs. We found that a disinfection cap was a very effective solution to the widely recognized shortcomings of the standard method for disinfecting IV connectors.”

Researchers also assessed the cost-effectiveness of the cap and concluded that its use resulted in net cost savings.

The study was undertaken because the standard protocol for manually disinfecting connector hubs, called “scrub the hub,” often fails because time-pressed nurses are not always able to properly scrub IV connectors with alcohol.

CLABSIs are a serious and often fatal form of infection that many hospitals have found difficult to control. The “scrub the hub” method of manual disinfection, with its inherent challenges, is often cited as a potential cause when a hospital’s CLABSI rate is high.

The study was designed to determine whether a disinfection cap overcame problems with manual disinfection. The cap (SwabCap; Excelsior Medical, Neptune, NJ) is a plastic device that twists onto the threads of the IV connector. Attaching it to the connector compresses a medical-grade foam pad inside the cap that releases isopropyl alcohol (IPA) onto the connector hub to disinfect it.

The cap is left in place between IV line accesses, and its retention seal keeps the connector bathed in alcohol while protecting it from contamination by external sources. An IV connector is a device that connects an IV catheter to tubing and helps deliver medications and nutrition. Incomplete disinfection of a connector can allow bacteria to enter the connector’s fluid pathway and cause an infection.

“Disinfection caps were invented because of the problems with ‘scrub the hub,’” Wright said. “Theoretically, they should compensate for those problems and provide additional protection for patients, as well. But you never know if something will work as intended until you do the research. Our study design showed in multiple ways that the cap was associated with fewer infections.”

About NorthShore University HealthSystem

Headquartered in Evanston, Illinois, NorthShore University HealthSystem (NorthShore) is a comprehensive, fully integrated, healthcare delivery system that serves the Chicago region. The system includes four hospitals in Evanston, Glenview, Highland Park and Skokie. NorthShore employs approximately 10,000 and has 2,400 affiliated physicians, including an 800+ physician, multispecialty group practice with over 100 office locations. Further, NorthShore supports teaching and research as the principal teaching affiliate for the University of Chicago Pritzker School of Medicine.

The NorthShore Research Institute focuses on clinical and translational research, including leadership in clinical trials and medical informatics. The NorthShore University HealthSystem Foundation is the primary philanthropic entity of NorthShore. The Foundation raises charitable contributions and engages volunteer friends in support of NorthShore’s ongoing mission to preserve and improve human life.

NorthShore has significant capabilities in a wide spectrum of clinical programs, including Kellogg Cancer Center, NorthShore Neurological Institute, cardiovascular care, orthopaedics, high-risk maternity and pediatrics. NorthShore is a Magnet recognized organization, the first in Illinois designated as a system to receive this prestigious honor that demonstrates excellence in nursing and high standards in patient care. NorthShore is a national leader in the implementation of innovative technologies, including electronic medical records (EMR). In 2003, NorthShore was among the first in the country to successfully launch a system-wide EMR with demonstrable benefits in quality, safety, efficiency and service to patients. NorthShore has been recognized by multiple national organizations for this notable achievement.

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