Use of Antiseptic Swabs Significantly Reduce Incidence of CLABSIs

The following article features coverage from the National Association of Clinical Nurse Specialists (NACNS) 2018 Annual Conference in Austin, Texas. Click here to read more of Oncology Nurse Advisor‘s conference coverage.

Use of antiseptic device swabs can prevent central line-associated bloodstream infections (CLABSIs) in oncology patients with central venous catheters (CVCs), a trial presented at the National Association of Clinical Nurse Specialists (NACNS) 2018 Annual Conference has shown.

Nursing practices that reduce hospital-acquired conditions, length of stay, and readmissions can improve hospital quality and financial sustainability. Central venous catheters are often used to administer treatments to patients with cancer; however, use of these devices increases the risk for CLABSIs in this patient population. Therefore, a CNS team conducted a cross-over trial in pediatric/adult oncology units with the goal of achieving 0 CLABSIs for a sustained period.

For the trial, researchers compared 2 disinfectant practices. The trial was conducted with a total of 243 (93 pediatric, 150 adult) patient admissions representing 5302 patient days.

In trial period 1, both units used Curos™ disinfecting caps plus Prevantics® device swabs (chlorhexidine gluconate [3.15%]/isopropyl alcohol [70%]) vs an alcohol pad to scrub the hub. In trial period 2, the Curos caps were not used and only the Prevantics device swabs were used.

The results showed that CLABSI rates declined significantly from the previous 6 months (baseline) in both units: 3.2/1000 line days to 1.1/1000 line days in the pediatric unit and 1.3/1000 line days to 0.83/1000 line days in the adult unit (P <.001). These results represent an overall improvement of 65% and estimated costs saving of $409,086.

Based on these results, use of Prevantics device swab for CVCs across all hospital units was approved. Use of the swabs resulted in a statistically significant decline (62%) in CLABSIs (P =.001). Furthermore, 0 CLABSIs were sustained across all settings in the 5-month posttrial period.

The author noted that this innovative initiative demonstrated CNS leadership and value within the organization to effect practice changes across the hospital setting, optimizing clinical outcomes and reducing costs.

Reference

Kalowes P. CNS driven quality initiative to reduce catheter-related bloodstream infections (CLABSIs) in oncology patients: a cross-over clinical trial comparing 3.15% chlorhexidine/70% isopropyl alcohol (CHG) vs 70% isopropyl alcohol for disinfection of needleless connectors (NC) with central lines. Oral presentation at: NACNS 2018 Annual Conference; February 28-March 3, 2018; Austin, TX.