Risk of infection due to medical interventions via central venous catheters or implantable venous access port systems at the middle port of a three-way cock: luer lock cap vs. luer access split septum system (Q-Syte).
Background: Many cancer patients receive a central venous catheter or port system prior to therapy to assure correct drug administration. Even appropriate hygienic intervention maintenance carries the risk of contaminating the middle port (C-port) of a three-way cock (TWC), a risk that increases wit...
| Publicado en: | BMC Infectious Diseases Vol. 14; no. 1; pp. 41 - 42 |
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| Autores principales: | , , , , , |
| Formato: | research Journal Article |
| Publicado: |
BioMed Central
2014
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=103811435&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 103811435 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 14712334 1CHU jtl: BMC Infectious Diseases issn: 14712334 maglogo: N pubinfo: dt: 2014 vid: 14 iid: 1 pid: 24147 pub: BioMed Central artinfo: ui: 103811435 103811435 NLM24460652 2012485898 10.1186/1471-2334-14-41 NLM24460652 PMC3932045 103811435 ppf: 41 ppct: 1 formats: tig: atl: Risk of infection due to medical interventions via central venous catheters or implantable venous access port systems at the middle port of a three-way cock: luer lock cap vs. luer access split septum system (Q-Syte). aug: au: Pohl, Fabian Hartmann, Werner Holzmann, Thomas Gensicke, Sandra Kölbl, Oliver Hautmann, Matthias G affil: Department of Radiotherapy, University Hospital Regensburg, Regensburg, Germany. fabian.pohl@ukr.de. sug: subj: Catheterization, Central Venous Adverse Effects Catheters Adverse Effects Central Venous Catheters Adverse Effects Infection Transmission Patient Safety Adult Catheterization, Central Venous Equipment and Supplies Catheters Economics Catheters Central Venous Catheters Economics Central Venous Catheters Costs and Cost Analysis Human Hygiene Infection Etiology Relative Risk Work Redesign Adult: 19-44 years ab: Background: Many cancer patients receive a central venous catheter or port system prior to therapy to assure correct drug administration. Even appropriate hygienic intervention maintenance carries the risk of contaminating the middle port (C-port) of a three-way cock (TWC), a risk that increases with the number of medical interventions. Because of the complexity of the cleaning procedure with disconnection and reconnection of the standard luer lock cap (referred as "intervention"), we compared luer lock caps with a "closed access system" consisting of a luer access split septum system with regard to process optimization (work simplification, process time), efficiency (costs) and hygiene (patient safety).Methods: For determination of process optimization the workflow of an intervention according to the usual practice and risks was depicted in a process diagram. For determining the actual process costs, we analyzed use of material and time parameters per intervention and used the process parameters for programming the process into a simulation run (n = 1000) to determine the process costs as well as their differences (ACTUAL vs. NOMINAL) within the framework of a discrete event simulation.Additionally cultures were carried out at the TWC C-ports to evaluate possible contamination.Results: With the closed access system, the mean working time of 5.5 minutes could be reduced to 2.97 minutes. The results for average process costs (labour and material costs per use) were 3.92 € for luer lock caps and 2.55 € for the closed access system. The hypothesis test (2-sample t-test, CI 0.95, p-value<0.05) confirmed the significance of the result.In 50 reviewed samples (TWC's), the contamination rate for the luer lock cap was 8% (4 out of 50 samples were positive), the contamination rate of the 50 samples with the closed access system was 0%.Possible hygienic risks (related to material, surroundings, staff handling) could be reduced by 65.38%.Conclusions: In the present research, the closed access system with a divided split septum was superior to conventional luer lock caps. The advantage of the closed access system lies in the simplified handling for staff, which results in a reduced risk of patient infection due to improved clinical hygiene. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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