When scrubbing isn’t enough….

At some point within the last 5 years, I am certain that all of us received some sort of training on how to prevent or reduce the incidence of catheter related blood stream infections (CR-BSI) associated with CVC. One of the things we’ve learned is in addition to the catheter hub, components of the IV access system such as needless connectors, injection ports, and stop-cocks have been identified as a significant risk for CRBSI. The CDC has recommended the practice of cleaning injection ports since 1982 but obviously compliance has been poor. The disinfection of connectors and injection ports is a simple procedure but how to actually accomplish complete disinfection is complex. There are variables to consider on achieving complete disinfection and currently, there are no specific evidence based guidelines on the “ideal” disinfectant or the “duration “of connector/injection ports disinfection. We were told to “scrub the hub” with an emphasis on the importance of friction when disinfecting but there remains a need for consistent and a reliable method for effective disinfection.

Several new disinfecting products are now available in the United States for use on needleless connectors and injection ports. The products are listed below in no particular order or preference. Each of these products has its own unique features and benefits both as connector cover and disinfecting device. All are designed to passively disinfect the connectors/injection ports, acts as a physical barrier to touch and airborne contamination, and assist in the standardization and promotion of compliance to connector/injection port cleaning.

This blog entry is not an endorsement of any of these products nor am I recommending any specific product. I, however have used one of the products and appreciate the value it brings  in preventing infections especially when nurses forget to disinfect the cap when accessing the access device or IV tubing for flushing or medication administration.  These devices will be particularly useful in protecting the connectors of CVC in ICU patients from exposure to trach drainage/ventilator moisture or any other suspicious materials in the patient’s neck/chest areas. I have no relationship whatsoever with the manufacturers of these products and I would highly recommend evaluating these products yourselves.