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October 16-20, 2010 San Diego, CA Home Abstract Archive Search Abstracts 2010 Session Grid 2010 Meeting Website Policy Statements ASA Website Feedback 
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A1083
October 20, 2009 9:00 AM - 11:00 AM Room Area E |
| Replacing Stopcock Caps on IV Tubing Reduces Contamination Rates; a Performance Improvement Study |
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John R. Benjamin, M.D., Meir Chernofsky, M.D. Department of Anesthesia, National Naval Medical Center, Bethesda, Maryland |
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Background:
Amid growing concerns about hospital acquired infections in an environment of increasing antibiotic resistance, health professionals are under increasing pressure to implement strategies to reduce the infection rate. Methods such as installing hand sanitizer stations outside of patient rooms to increase physician hand washing have met with success (1, 2). Although much data exists on central line infection rates and prevention, there is relatively little research into the prevalence of perioperative peripheral IV catheter transmission of infection (3).
Methods: Our performance improvement team had informally identified the fact that patients often arrived in the Post Anesthesia Care Unit (PACU) with injection ports uncapped. In this performance improvement study, patients recovering in the PACU were randomly selected and their IV manifold stopcock injection ports were swabbed and cultured. The presence of the caps on the IV stopcock manifold injection ports was recorded. All patients had the same standard IV set with a 3-port manifold which comes with 3 caps in the original packaging, and 2 valved injection ports which do not come capped. Midway through the study period, anesthesia providers were made aware of the study and encouraged to replace the caps after use of injection ports during the anesthetic. We then continued to record the same data for the rest of the month, comparing both recapping (Mann-Whitney Test) and contamination (Fisher's Exact Test) rates. The null hypotheses were that the rate of capped injection ports would not increase after the educational intervention and the rate of bacterial contamination would not decrease. Results: Bacterial contamination was significantly greater on stopcocks that were uncapped upon admission to the PACU (77 vs. 36%, p = 0.0003 ). After anesthesia providers were made aware of the study and encouraged to keep the ports capped, the rate of recapping increased significantly (45.7 vs. 74%, p = 0.002 ) and there was a corresponding decrease in the rate of stopcock contamination (29.2 vs. 9.9%, p = 0.001 ). From Proceedings of the 2009 Annual Meeting of the American Society Anesthesiologists. |