WK 6 DQ – Implementation of CLABSI bundles

WK 6 DQ – Implementation of CLABSI bundles

WK 6 DQ – Implementation of CLABSI bundles

Studies show that colonization of central line hubs causes 50% of post-insertion catheter-related infections. The development and implementation of CLABSI bundles have resulted in an appreciated reduction but not the elimination of central line infections.  Included in the bundle is disinfection of the access hubs (including drying time). Manual disinfection of hubs require a multi-step approach. One such approach is the use of a scrubbing device with an alcohol product such as chlorhexidine with alcohol or 70% alcohol to disinfect catheter hub and stopcocks. However, it is well documented that compliance with this technique is low, creating a significant safety risk (Barton, 2019).

The manual disinfection requires a multi-step approach, but poor technique (lapses in aseptic technique) in manual disinfection is significantly affected by human factors such as workload, stress, competency and training. One way of mitigating this is to use passive disinfecting caps. Also known as port protectors, these are devices that are impregnated with an antiseptic agent and connected to the luer fitting of a central line hub.

They act as a physical barrier between line accesses. Studies demonstrate that passive disinfecting caps are effective in decreasing the rate of CLABSI. Systematic reviews and meta-analyses found that passive disinfecting caps significantly reduced the incidence of CLABSI compared to manual disinfection. Researchers concluded that passive disinfecting caps should be considered for inclusion in central-line maintenance care bundles (Moureau, 2014).

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Reference:

Barton, A. (2019). The case for using a disinfecting cap for needlefree connectors. British

Journal of Nursing, 28(14), S22–S27.

Retrieved from https://www.ivteam.com/intravenous-literature/the-case-for-using-a-

disinfecting-cap-for-needlefree-connectors/

Moureau, N. L. (2014). Catheter-associated bloodstream infection prevention: what is

missing? British Journal of Healthcare Management, 20(11), 502–510. Retrieved from

https://search-ebscohost-com.southuniversity.libproxy.edmc.edu/login.aspx?direct=true&db=rzh&AN=107837436&site=ehost-live&scope=site

PICOT Question

Evidence Table Worksheet

1. PICOT Question:

plus

1. Will you have a comparison group or will subjects be their own controls?
2. Is a ‘time’ appropriate with your question—why or why not?

II.    Evidence Synthesis

 

(database) ex: Cochran	Study #1	Study #2	Study #3	Study #4	Study #5	Synthesis
(p) Population
(i) Intervention
(c) Comparison
(o) Outcome
(t) time

 

• Evaluation Table

 

Citation	Design	Sample size: Adequate?	Major Variables:   Independent Dependent	Study findings: Strengths and weaknesses	Level of evidence	Evidence Synthesis