Work

866Observational Study of Central Venous Catheter (CVC) Occlusions and Central Line-Associated Blood Stream Infections (CLABSI) Using the Clave™ Negative Displacement Connector

Year: 2014

Type: conference-abstract

Abstract: Background. We performed a year-long observational study in a large cohort of patients to evaluate the incidence of CLABSI and CVC lumen occlusion using a negative displacement connector in a setting where disinfection caps containing 70% isopropyl alcohol cover all unused connectors. Methods. CVCs placed between October 2012 and October 2013 at NorthShore (4 hospitals, 832 beds) were prospectively monitored for the development of CLABSI and/or CVC lumen occlusion. Patients were followed from the time of CVC insertion through 2 days following removal or through final hospital discharge if there was no documentation of removal. CLABSI was defined using NHSN criteria. Relevant data including evidence of lumen clots (e.g., ultrasound or use of plasminogen activators) were abstracted from the electronic medical record (EMR) and medical staff interview. Direct observations were performed on a subset of patients to assess adherence to hospital policy regarding the insertion and maintenance of CVCs. Results. Throughout the 12 month study, 2,264 patients underwent CVC placement. 85 direct observations demonstrated insertion protocol adherence in 881 of 925 (95%) measured criteria. There were 21 CLABSI for a rate of 0.84% of lines and 0.62 per 1,000 line days. 378 clots occurred for a rate of 15.05% of lines and 11.23 per 1,000 line days. Infection and clot rate by hospital are in the table. Infection and clot rate by hospital *, p>0.05 for all; †, p<.0001 for 1 vs 2, or 3, or 4 Conclusion. In this very large study of CVC-related complications we demonstrated that lines placed with standardized methods using a negative displacement connector and a disinfection cap can achieve very low rates of complications. The risk of infection was 5 to 10-fold lower than previously reported. Assessment of new devices should approach clinical trials with the concept that very low rates of complications are achievable using contemporary devices and practices. Disclosures. L. Peterson, Cepheid: Investigator, Research grant

Source: Open Forum Infectious Diseases

DOI: 10.1093/ofid/ofu052.574