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International Journal of Infection Control最新文献

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Use of different designed needle-free connectors: a snapshot of central venous catheter intraluminal blood occlusion and central line–associated bloodstream infection in hospitals 使用不同设计的无针连接器:医院中心静脉导管管腔内血液闭塞和中心静脉相关血流感染的快照
Pub Date : 2024-08-09 DOI: 10.3396/ijic.v20.23731
Victor R. Lange
Background: Needle-free connectors (NCs), originally designed to improve the safety of healthcare workers, are increasingly being used to mitigate central line–associated bloodstream infection (CLABSI) and central venous catheter intraluminal blood occlusion (CVC-IBO) in patients. There are numerous NCs on the market, with varied internal and external designs and features.Objectives: The purpose of this study was to compare the frequency, clinical, and financial impact of CVC-IBO and CLABSI among 16 California (USA) hospitals using differently designed NCs.Method: Data were collected by sending a survey to the hospitals, which had varying bed capacities and patient populations that were committed to reducing CVC-IBO and CLABSI. In each hospital, CLABSI rates were tracked as defined by the National Healthcare Safety Network.Results: Hospitals using the BD MaxPlus™ or MaxZero™ Needle-free Connector, the only device with a solid external access surface, were found to have a significantly lower CLABSI rate (1.32 vs. 2.95 per 1,000 central-line days [CLDs]; P = 0.0052) and CVC-IBO rate (1.51 vs. 4.04 per 1,000 CLDs; P = 0.0065) versus those using devices with a nonsolid access surface.Conclusion: Hospitals using the MaxPlus™ or MaxZero™ NC also had significantly higher cost saving (per 100 patient days) associated with lower use of tissue plasminogen activator versus devices with a nonsolid access surface ($219 vs. $510 USD; P = 0.01). These results highlight the clinical importance of NC design components and their contributions to risk of CLABSI and catheter occlusion.
背景:无针连接器(NC)最初是为了提高医护人员的安全性而设计的,现在越来越多地用于减少患者的中心静脉管相关血流感染(CLABSI)和中心静脉导管腔内血液闭塞(CVC-IBO)。市场上有众多的 NC,其内部和外部设计及功能各不相同:本研究旨在比较美国加利福尼亚州 16 家使用不同设计数控系统的医院发生 CVC-IBO 和 CLABSI 的频率、临床和财务影响:方法:通过向致力于减少 CVC-IBO 和 CLABSI 的医院发送调查问卷来收集数据,这些医院的床位数和患者人数各不相同。每家医院都按照国家医疗安全网络(National Healthcare Safety Network)的规定跟踪 CLABSI 感染率:使用 BD MaxPlus™ 或 MaxZero™ 无针连接器(唯一具有坚固外部通路表面的设备)的医院与使用非坚固通路表面设备的医院相比,CLABSI 感染率(每 1,000 个中心管路日 [CLDs] 1.32 例 vs. 2.95 例;P = 0.0052)和 CVC-IBO 感染率(每 1,000 个中心管路日 1.51 例 vs. 4.04 例;P = 0.0065)显著降低:结论:使用 MaxPlus™ 或 MaxZero™ NC 的医院与使用非固体通路表面的设备相比,由于组织纤溶酶原激活剂的使用率较低,因此节省的成本(每 100 个患者日)也明显更高(219 美元对 510 美元;P = 0.01)。这些结果凸显了 NC 设计组件的临床重要性及其对 CLABSI 和导管闭塞风险的影响。
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International Journal of Infection Control
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