Enhancing Safety in Clinical Practice: Cross-Sectional, Within-Subjects, Simulated-Use Compliance Study Using BD...

Needleless access devices are essential for intravenous therapy but can be a source of contamination and catheter-related bloodstream infections (CRBSIs) if not disinfected properly. The BD PosiFlush SafeScrub (Becton, Dickinson and Company) is designed to support aseptic nontouch technique (ANTT) by incorporating a built-in reminder to "scrub-the-hub" before flushing. This feature can help improve compliance with disinfection practices and may reduce the risk of microbial contamination.

This study aimed to evaluate compliance with scrubbing before flushing using the BD PosiFlush SafeScrub in a simulated clinical environment compared with standard disinfection and flushing practices (alcohol swabs and prefilled saline syringes).

A cross-sectional, within-subjects, simulated-use compliance study was conducted with health care professionals familiarized with BD PosiFlush SafeScrub (a prefilled BD PosiFlush Syringe with an integrated disinfecting unit). Compliance was defined according to the disinfection procedure specified for each scenario; participants were considered compliant with standard practice if they followed their own institutional policy (ranging from 5 to 30 seconds or based on stroke counts), while compliance with BD PosiFlush SafeScrub required scrubbing for at least 10 seconds with a minimum of 8 clockwise and 8 counterclockwise rotations, in accordance with the instructions for use (IFU). Compliance with disinfection was monitored and recorded for both the BD PosiFlush SafeScrub and standard disinfection and flushing practice.

Compliance with catheter hub disinfection was assessed among 60 participants for BD PosiFlush SafeScrub and 57 participants for standard practice. During preaccess procedures (Flush 1), BD PosiFlush SafeScrub achieved 46% compliance versus 21% with standard practice, representing an absolute improvement of 25% and a 119% relative improvement (P<.001). During the postmedication procedure (Flush 2), compliance was 22% with BD PosiFlush SafeScrub compared with 13% for standard practice, corresponding to a 9% absolute improvement and 69% relative improvement, although not statistically significant (P=.12). Overall, the compliance rate was 34% (81/240 interactions) in the BD PosiFlush SafeScrub group compared with 17% (39/228 interactions) in the standard practice group, representing an absolute improvement of 17% and a relative improvement of 100% (P<.001).

The BD PosiFlush SafeScrub, with its integrated disinfection unit, yielded approximately double the scrub-the-hub compliance (34%) before flushing compared to the standard practice of alcohol pads and prefilled saline syringes (17%), supporting its role in facilitating adherence to ANTT, which may reduce microbial growth.