A study and review performed by clinicians of PICC Excellence, Inc. found a disinfection cap that dispenses 70 percent isopropyl alcohol is effective in disinfecting IV needleless connectors after five minutes. The study shows that if a needleless connector is covered and bathed in alcohol by the disinfection cap, no drying time is required to kill nearly all pathogens on the connector. The study is significant for two reasons:
- Proper IV connector disinfection between catheter line accesses is a crucial step in preventing contamination and potentially fatal catheter-related bloodstream infections (CRBSIs).
- Compliance with needleless connector cleansing is notoriously poor with methods that require manual disinfection of the connectors.
The results of the study were reported in a scientific poster presentation at the 2010 annual meeting of the Association for Vascular Access (AVA), a leading national organization focusing on patient safety and best nursing practices. The study's authors are PICC Excellence founder Nancy Moureau, RN, BSN, CRNI, CPUI and Robert B. Dawson, MSA, BSN, RN, CRNI, CPUI.
"This study indicates that needleless connectors are adequately cleansed using a passive technology that covers and protects access sites until the next usage," Moureau said.
The in vitro study evaluated the ability of a device called SwabCap® to passively disinfect needleless connectors between line accesses. The study was prompted in part by research reporting that 31 percent of nurses do not disinfect valves before accessing the lines.
SwabCap is designed to disinfect connectors when it is twisted onto the threads of the connector. The act of twisting the cap onto the connector depresses a foam pad inside the cap saturated with 70 percent isopropyl alcohol. The pad dispenses the alcohol onto the connector top and threads.
In this study, six different types of needleless connectors were inoculated with four organisms associated with CRBSIs. The SwabCap was then attached to the connectors for five minutes.
Five units of each connector type were inoculated with each of the four organisms for a total of 120 units tested. The results of the test showed the disinfection cap completely prevented bacteria colonization in almost all cases. On 109 of the 120 units, zero colony-forming units (CFUs) were found. On the remaining 11 units, a maximum of five CFUs were found.
"Compliance with manual cleaning of caps prior to access is known to be poor, so a device that passively disinfects connectors is a valuable alternative to manual disinfection methods that require friction and adequate time to work," Moureau said. "Also, the disinfection cap thoroughly removes pathogens from the connector meaning that when the catheter line is next accessed, you have the security of knowing the needleless connector is clean."
PICC Excellence is an educational company that provides programs for PICC and intravenous training, certification and infection prevention education for clinicians who insert PICCs, CVCs and peripheral catheters. PICCs provide medication and nutrition to patients who are often quite ill and are more vulnerable to CRBSIs.
CRBSIs are one of the leading hospital-acquired infections and one of the nations leading killers overall. They are fatal in up to 25 percent of cases. According to the Institute for Healthcare Improvement, they also cost an estimated $34,000 to $56,000 per incident to treat, adding substantially to the cost of healthcare.
SwabCap is made by Excelsior Medical (Neptune, N.J.) The annual AVA 2010 meeting was held Sept. 24-26, 2010 in National Harbor, Md.