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Reducing CLABSIs via Antiseptic Barrier Caps Among Patients Undergoing Transplantation or Cellular Therapy: A Quality
Sarah Rowland Rutledge1, Sarah B Kibbee2, Julie Kleber3
1Sarah Rowland Rutledge.
Background:
Central line-associated bloodstream infections (CLABSIs) pose serious risks for patients undergoing stem cell transplantation and cellular therapy and remain a challenge for healthcare teams and facilities.
Objectives:
A quality improvement project was developed to assess the impact of antiseptic barrier caps (ABCs) on CLABSI reduction on a stem cell transplantation and cellular therapy unit.
Methods:
During a six-month trial, ABCs were applied to the lumens and hubs of all venous access devices in patients with central venous catheters. ABCs were used as an additional layer of protection in conjunction with mechanical disinfection of lumens and hubs and the facility's CLABSI prevention bundle. CLABSI data were monitored monthly, and compliance with ABC use and mechanical disinfection was assessed through leader rounding. During leader rounding, a standardized form was employed, incorporating a visual audit component and a patient/family interview component. The interview assessed whether nurses consistently performed mechanical disinfection after removing the ABC and prior to accessing needleless connectors or IV tubing hubs.
Findings:
There was a 68% reduction in CLABSI events. By the end of 2024, the unit achieved a CLABSI standardized infection ratio of 0.414, representing a substantial improvement compared to the 2023 ratio of 1.45. The cost avoidance from ABC implementation was about $320,787. CLABSI reduction was sustained in 2025, and ABCs were implemented on the hematology-oncology unit.
