Study Sees Reduction of CLABSIs in Home Care Setting

The SwabCap disinfection cap was shown to reduce central line-associated bloodstream infections (CLABSIs) among home-care patients receiving infusion therapy, according to a poster presented at the American Society of Parenteral and Enteral Nutrition conference.

The poster authors concluded that the use of a disinfection cap on central venous catheters may lower CLABSI risk for parenteral nutrition patients and multi-lumen catheter patients, who are more vulnerable to catheter infections.

Among patients who used SwabCap according to the recommended protocol, there were no CLABSIs.

Authors Michelle Pratt, RN and Melissa Leone, RN, BSN, of Coram Specialty Infusion Services, reported the results of a six-month trial of SwabCap. The trial was a single-site study looking at CLABSI infections in patients using the SwabCap as compared to patients not using the SwabCap.

The SwabCap trial was initiated after Coram considered several options for improving catheter antisepsis. The cap was provided to all parenteral nutrition and multi-lumen central venous access device (CVAD) patients in a single branch for attachment to the injection port (needleless IV connector) between IV line accesses.

"Disinfection caps are an exciting new development in home infusion therapy," says Leone. "Our study indicates that use of a disinfection cap may reduce bloodstream infections. When we supplement alcohol-pad, manual antisepsis with the cap, the IV connector is in continual contact with alcohol. That likely accounts for the reduced infection rate with the cap."

In the Coram trial, all parenteral nutrition and multi-lumen CVAD patients were taught to connect the disinfection cap to their IV connectors after medication administration was completed, and then leave it in place until the injection port was accessed again. Follow-up phone calls were made to patients to confirm they were complying with cap use.

Home infusion parenteral nutrition patients are potentially at higher risk for CLABSIs than many other patients because they may have compromised immune systems and multiple other serious health issues. In addition, their catheters often require long dwell times, which increase the likelihood that an infection will develop. Finally, about half of parenteral nutrition patients have multi-lumen CVADs, which provide additional locations for bacteria to enter.

SwabCap is a simple twist-on device that disinfects swabable needleless IV connectors (injection ports) in between line accesses. The FDA-cleared device passively disinfects the valve top and threads via sustained contact with 70 percent isopropyl alcohol. It also provides a physical barrier to contamination.

The American Society of Parenteral and Enteral Nutrition (ASPEN) conference was held earlier this year in Vancouver.