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Lowered Incidence of Central Venous Catheter Related Blood Stream Infections using a Neutral Fluid Displacement with Double Microbial Barrier and Zero Dead Space Intravenous Connector

Stephanie Harris

D. Martin

Denise Bagford

M. Fargotstein

M. Johlie


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Conference: 2012 International PHA Conference and Scientific Sessions

Release Date: 06.22.2012

Presentation Type: Abstracts

Harris S.1, Martin D.2, Bagford D.2, Fargotstein M.2, Johlie M.2

1. University of Washington Medical Center, Seattle, WA and 2. CVS Caremark, Northbrook, IL

PURPOSE: Evaluate the rate of blood stream infections (BSI’s) in patients receiving IV Prostacyclin when using an injection cap with neutral fluid displacement, zero dead space and a double microbial barrier versus prior use of a negative fluid displacement with a split septum injection cap.

BACKGROUND: Patients with central venous catheters have an increased risk of developing BSIs. BSIs are a major cause of healthcare-associated morbidity and mortality. CDC has reported more than 250,000 central line –associated BSIs in the US yearly1.

METHODS: As part of ongoing care for infused prostacyclin shared patients, The University of Washington Medical Center partnered with CVS Caremark Specialty Pharmacy to evaluate, post utilization, outcomes relating to the use of an injection cap with neutral fluid displacement, double microbial barrier, with zero dead space and a low priming volume in Pulmonary Arterial Hypertension patients on intravenous prostacyclin therapy. A total of 35 patients were evaluated for BSI related to their intravenous therapy. As part of a quality review, the patients were assessed for signs and symptoms of central line infections from March 2010 through September 2010 prior to transition to the new injection cap. There was a 10% infection rate in this patient population utilizing the negative displacement, split septum connector. Patients were changed over to the new connector and evaluated October 2010 through April 2011. Post transition infection rates were at 0%. All patients were switched to the connector and closely assessed for 6 months. No other changes were made in catheter care or maintenance. This was not done as part of a research study, no controls were used, no IRB review or approval were requested or granted, and that this was based on a post-hoc review of use of the injection caps.

RESULTS: During the post transition 6 months, October 2010 to April 2011, no central line catheter BSIs were reported.Patients reported ease of use, no spontaneous disconnects, and no medication leak, no blood backup and no catheter clotting issues.

CONCLUSION: The outcomes are suggestive that use of the injection cap correlated with improved outcomes.

REFERENCES: Klevens RM, Edwards JR, Richards CL, Horan TC, Gaynes RP, Pollock DA, Cardo DM. Estimating Health Care-Associated  Infections and Deaths in U.S. Hospitals, 2002. Public Health Reports 2007;122:160-166