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The case for using a disinfecting cap for needlefree connectors

25 July 2019
Volume 28 · Issue 14


Catheter-related bloodstream infections (CRBSIs) are a signification cause of infection. When CRBSI rates are high, the cost to the patient and the organisation can be significant. More than ever before, there is a high demand for vascular access. Advances in treatment often entail extended indwell times for central vascular access devices. The care and maintenance of these devices is crucial in avoiding complications such as infection. Using care bundles in conjunction with other simple interventions, such as passive disinfecting caps, can help reduce CRBSI rates. The published evidence demonstrates that passive disinfecting caps can help reduce infection rates associated with different types of central venous catheters by protecting needlefree connectors from colonisation by pathogens and serving as a clear indicator that the line has been disinfected.

Healthcare-associated infection is a major patient safety concern that causes morbidity, mortality and increased healthcare costs. The prevention, or at least significant reduction, of catheter-related bloodstream infections (CRBSIs) requires a multimodal approach, with adherence to rigorous application of standardised infection prevention and control behaviours (Loveday et al, 2014). Vascular access remains the most frequent invasive procedure undertaken in healthcare, with 60% of patients in the UK and 80% in the US requiring intravenous (IV) access (Lavery and Ingram, 2005; Hadaway, 2012; Wallis et al, 2014). However, the lack of compliance to best practice by many health professionals continues to create a high risk of infection and other complications.

In 2016, Pronovost et al published research on the progress of the first version of the Michigan Keystone project research data, which had been initiated in 2009. The results demonstrated a significant reduction in central venous catheter-related infection following implementation of simple infection-control practices such as standardised skin decontamination before catheter insertion; use of sterile drapes, gowns and gloves; and use of ultrasound to cannulate the vessel. (By reducing multiple needlesticks, ultrasound will not only increase vessel health but also reduce the number of breaches in the skin, and thus the risk of contamination and infection.)

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