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Use of Disinfection Cap to Reduce Central-Line–Associated Bloodstream Infection and Blood Culture Contamination Among Hematology–Oncology Patients

Published online by Cambridge University Press:  23 September 2015

Mini Kamboj ,
Rachel Blair ,
Natalie Bell ,
Crystal Son ,
Yao-Ting Huang ,
Mary Dowling ,
Allison Lipitz-Snyderman ,
Janet Eagan  and
Kent Sepkowitz
Mini Kamboj*
Affiliation:
Infection Control and Infectious Disease Service Memorial Sloan Kettering Cancer Center, New York, New York Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York Department of Medicine, Weill Cornell Medical College, New York, New York
Rachel Blair
Affiliation:
Infection Control and Infectious Disease Service Memorial Sloan Kettering Cancer Center, New York, New York
Natalie Bell
Affiliation:
Infection Control and Infectious Disease Service Memorial Sloan Kettering Cancer Center, New York, New York Department of Nursing, Memorial Sloan Kettering Cancer Center, New York, New York
Crystal Son
Affiliation:
Infection Control and Infectious Disease Service Memorial Sloan Kettering Cancer Center, New York, New York
Yao-Ting Huang
Affiliation:
Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
Mary Dowling
Affiliation:
Department of Nursing, Memorial Sloan Kettering Cancer Center, New York, New York
Allison Lipitz-Snyderman
Affiliation:
Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
Janet Eagan
Affiliation:
Infection Control and Infectious Disease Service Memorial Sloan Kettering Cancer Center, New York, New York
Kent Sepkowitz
Affiliation:
Infection Control and Infectious Disease Service Memorial Sloan Kettering Cancer Center, New York, New York Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York Department of Medicine, Weill Cornell Medical College, New York, New York
*
Address correspondence to Mini Kamboj, MD, 1275 York Avenue Box 9, New York, NY 10065 ([email protected]).
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Abstract

OBJECTIVE

In this study, we examined the impact of routine use of a passive disinfection cap for catheter hub decontamination in hematology–oncology patients.

SETTING

A tertiary care cancer center in New York City

METHODS

In this multiphase prospective study, we used 2 preintervention phases (P1 and P2) to establish surveillance and baseline rates followed by sequential introduction of disinfection caps on high-risk units (HRUs: hematologic malignancy wards, hematopoietic stem cell transplant units and intensive care units) (P3) and general oncology units (P4). Unit-specific and hospital-wide hospital-acquired central-line–associated bloodstream infection (HA-CLABSI) rates and blood culture contamination (BCC) with coagulase negative staphylococci (CONS) were measured.

RESULTS

Implementation of a passive disinfection cap resulted in a 34% decrease in hospital-wide HA-CLABSI rates (combined P1 and P2 baseline rate of 2.66–1.75 per 1,000 catheter days at the end of the study period). This reduction occurred only among high-risk patients and not among general oncology patients. In addition, the use of the passive disinfection cap resulted in decreases of 63% (HRUs) and 51% (general oncology units) in blood culture contamination, with an estimated reduction of 242 BCCs with CONS. The reductions in HA-CLABSI and BCC correspond to an estimated annual savings of $3.2 million in direct medical costs.

CONCLUSION

Routine use of disinfection caps is associated with decreased HA-CLABSI rates among high-risk hematology oncology patients and a reduction in blood culture contamination among all oncology patients.

Infect. Control Hosp. Epidemiol. 2015;36(12):1401–1408

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 36 , Issue 12 , December 2015 , pp. 1401 - 1408
Copyright
© 2015 by The Society for Healthcare Epidemiology of America. All rights reserved 

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Footnotes

PREVIOUS PRESENTATION: This work was presented in part as poster abstract session no. 119, October 19, 2012 at ID Week 2012, San Diego, California.

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