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Peripheral intravenous catheter needleless connector decontamination study-Randomized controlled trial.

Karen Slater1, Marie Cooke2, Fiona Fullerton3

  • 1Princess Alexandra Hospital, Brisbane, Australia; School of Nursing and Midwifery, Griffith University, Brisbane, Australia.

American Journal of Infection Control
|January 14, 2020
PubMed
Summary
This summary is machine-generated.

Needleless connectors (NCs) decontamination using 70% isopropyl alcohol (IPA) or chlorhexidine gluconate (CHG) in IPA was highly effective. A 5-second application of 70% IPA is recommended for NC decontamination to prevent bloodstream infections.

Keywords:
Blood stream infectionMicrobiology

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Area of Science:

  • Infection Control
  • Healthcare-Associated Infections
  • Medical Device Decontamination

Background:

  • Needleless connectors (NCs) are crucial for reducing needlestick injuries but can transmit bloodstream infections if not properly decontaminated.
  • The optimal disinfectant and contact time for effective NC decontamination remain empirically unestablished, posing a risk to patient safety.
  • Microbial contamination of NCs is a significant concern in healthcare settings, necessitating effective decontamination protocols.

Purpose of the Study:

  • To compare the efficacy of 70% isopropyl alcohol (IPA) versus 2% chlorhexidine gluconate (CHG) in 70% IPA for decontaminating needleless connectors.
  • To determine the optimal application duration (5, 10, or 15 seconds) for NC decontamination in a clinical setting.
  • To provide evidence-based recommendations for NC decontamination to prevent healthcare-associated infections.

Main Methods:

  • A factorial design randomized controlled trial was conducted involving adult patients with peripheral intravenous catheters.
  • Disinfectants tested included 70% IPA and 2% CHG in 70% IPA, with application durations of 5, 10, and 15 seconds.
  • Microbial growth from NCs was assessed at baseline and after decontamination procedures.

Main Results:

  • At baseline, 51% of NCs showed microbial contamination, primarily skin flora.
  • Decontamination was successful in 98% of contaminated NCs, with no significant difference between 70% IPA and 2% CHG in 70% IPA (P=.62).
  • Application duration (5, 10, or 15 seconds) did not significantly impact decontamination efficacy (P=.21), although 15 seconds did not guarantee complete microbial removal.

Conclusions:

  • Both 70% IPA and 2% CHG in 70% IPA are effective for NC decontamination in clinical settings.
  • A 5-second application of 70% IPA is a cost-effective, feasible, and acceptable approach for NC decontamination, balancing efficacy and compliance.
  • The study supports the use of shorter decontamination times, recommending 5 seconds with 70% IPA as a practical standard for needleless connectors.