Disinfection caps better than scrub-the-hub approach, study finds
MAYWOOD, Ill. (June 5, 2014) – Loyola University Medical Center achieved a 68 percent decrease in the overall number of central-line-associated bloodstream infections (CLABSI) over a 12-month period. A two-year study compared the use of disinfection caps with an intense scrub-the-hub intervention to standard care. Scrub-the-hub refers to cleaning catheter connector hubs and injection ports with alcohol for the recommended 15 seconds before accessing the central line, a catheter placed in a large vein to deliver medicine and liquids during hospitalization.
“Loyola discovered that 80 percent of infections occurring in the scrub-the-hub arm were related to not scrubbing the hub for the required full 15 seconds,” said Marcelina M. Wawrzyniak, '13 MSN, '08 BSN, RN, study author and infection preventionist at Loyola University Medical Center. “Substituting the use of alcohol-impregnated caps was very well received by staff due to the ease of use. Implementation of the caps sustained a reduction in CLABSI over the long term."
Wawrzyniak, who recently earned her master's degree from Loyola University Chicago Marcella Niehoff School of Nursing, presented the Loyola study in June at the annual conference of the Association for Professionals in Infection Control and Epidemiology (APIC). Wawrzyniak received the Young Investigator Award as primary author of the Loyola study.
The cost of CLABSI is estimated at $45,814 per infection, according to a recent analysis published in the Journal of the American Medical Association Internal Medicine. “Loyola went from 59 to just 23 CLABSIs within a 12-month period after using the alcohol caps, reducing hospital costs by more than $1 million,” said Jorge Parada, MD, MPH, FACP, FIDSA, professor of medicine at Loyola University Chicago Stritch School of Medicine. “Alcohol-impregnated caps were an added cost, but documentation of the increased patient safety coupled with the reduction in CLABSI costs made it easy to receive administration approval."
Loyola also showcased a poster presentation of “Infection Prevention Denominator Data Collection Opportunities in a University Medical Center” at the national conference.
Loyola has 140 intensive care unit (ICU) beds in its 569-licensed-bed academic medical center located outside Chicago. Loyola University Health System is recognized internationally as a leader in infection control and prevention. Loyola is one of a few U.S. hospitals that invests in universal MRSA screening of all inpatients. Loyola was one of the first institutions to require all staff have mandatory flu shots as a condition of employment. And Loyola actively screens emergency department patients for HIV/AIDS as part of an ongoing research study.