Flynn, Julie M. 
ORCID: https://orcid.org/0000-0003-1512-2089 and Larsen, Emily N. and Keogh, Samantha and Ullman, Amanda J. and Rickard, Claire M.
(2019)
Methods for microbial needleless connector decontamination:
A systematic review and meta-analysis.
American Journal of Infection Control, 47 (8).
pp. 956-962.
ISSN 0196-6553
Abstract
Background: The objective of this review was to compare the effectiveness of connector decontamination with 70% alcohol wipes, alcoholic chlorhexidine gluconate wipes, or alcohol impregnated caps to prevent catheter-associated bloodstream infection (CABSI). Methods: A systematic search was conducted in CINAHL, Cochrane Central Register of Controlled Trials, Medline, and PubMed. The primary outcome was CABSI, with randomized and observational studies included. The inclusion criteria were: English language, any age group, no date limitations, and reporting connector decontamination interventions to prevent CABSI. The exclusion criteria were: multimodal interventions, letters, and conference abstracts. Quality assessment with the Newcastle-Ottawa Scale, a narrative synthesis, and meta-analysis were conducted. Pooled data used a random effects model for pair-wise comparisons, due to clinical heterogeneity. Statistical heterogeneity was investigated by visual model inspection, χ², and I² statistics. Results: Ten studies compared 70% alcohol wipes with 70% alcohol-impregnated caps, and 2 studies (n = 1,216) tested an alcoholic chlorhexidine gluconate wipe. Alcoholic chlorhexidine gluconate wipes were associated with significantly less CABSI than 70% alcohol wipes (risk ratio, 0.28; 95% confidence interval, 0.20-0.39). Alcohol-impregnated caps were associated with significantly less CABSI than 70% alcohol wipes (risk ratio, 0.43; 95% confidence interval, 0.28-0.65). Studies were of low to moderate quality. Conclusions: Alcohol impregnated caps and alcoholic chlorhexidine gluconate wipes were associated with significantly less CABSI than 70% alcohol wipes. This requires confirmation in randomized controlled trials.
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| Item Type: | Article (Commonwealth Reporting Category C) |
|---|---|
| Refereed: | Yes |
| Item Status: | Live Archive |
| Additional Information: | Response to article in https://eprints.usq.edu.au/44699/ |
| Faculty/School / Institute/Centre: | No Faculty |
| Faculty/School / Institute/Centre: | No Faculty |
| Date Deposited: | 10 Dec 2021 01:03 |
| Last Modified: | 16 Dec 2021 03:20 |
| Uncontrolled Keywords: | Bloodstream infection; CABSI; CLABSI; Vascular access device |
| Fields of Research (2008): | 11 Medical and Health Sciences > 1110 Nursing > 111003 Clinical Nursing: Secondary (Acute Care) 11 Medical and Health Sciences > 1110 Nursing > 111099 Nursing not elsewhere classified |
| Fields of Research (2020): | 42 HEALTH SCIENCES > 4205 Nursing > 420506 Sub-acute care 42 HEALTH SCIENCES > 4205 Nursing > 420501 Acute care 42 HEALTH SCIENCES > 4205 Nursing > 420599 Nursing not elsewhere classified |
| Identification Number or DOI: | https://doi.org/10.1016/j.ajic.2019.01.002 |
| URI: | http://eprints.usq.edu.au/id/eprint/44662 |
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