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Drop in Central-Line Infection Rates Linked to Disinfection Caps

Cheryl Clark, for HealthLeaders Media, January 4, 2013

But in the Phase 2, which ran during parts of 2010 and 2011, clinicians used a tiny bright orange disinfection cap, sold under the brand name SwabCap. The manufacturer paid for the cost of the study under a testing protocol, which obtained human subject review approval, but NorthShore hospitals purchased the caps.

The cap acts as a hood for an even tinier sponge that's saturated with 70% isopropyl alcohol. When twisted onto the IV catheter, the cap squeezes the alcohol in the sponge into the connector, killing any bacteria within five minutes.

The percentage of catheters sampled with contamination went from 12.4%, 12.7% and 13.3%, respectively in each of the three hospitals during Phase 1, to 6.5%, 3.6% and 3.2% in Phase 2.

For Phase 3, which ended in 2011, Wright and colleagues wanted to be sure that some other infection control initiative wasn't responsible for the improvement. So the largest facility, Evanston Hospital, continued the study by going back to the standard "scrub the hub" technique used in Phase 1.

Contamination rates resumed to 12.6%, or about where they were in Phase 1, and NorthShore ended the study.

When the trial ended 18 months ago, the hospitals were sold on the strategy, especially after a cost analysis revealed that the caps, which cost .20 to .30 a piece, at a total cost per day of $2 per day per catheterized patient, cost NorthShore's four facilities a total of only $60,000 per year. "It was a slam dunk," Wright says.

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