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).
Reference:
Barton, A. (2019). The case for using a disinfecting cap for needlefree connectors. British
Journal of Nursing, 28(14), S22–S27.
Retrieved from
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
- PICOT Question:
plus
- Will you have a comparison group or will subjects be their own controls?
- 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 |
