Study: Methodist Hospitals reduced infections through widespread use of IV cap - March 10, 2015

Courtesy of NWI Times
March 10, 2015 10:30 pm  •  Giles Bruce giles.bruce@nwi.com, (219) 853-2584

MERRILLVILLE | Methodist Hospitals reduced its bloodstream infections by roughly half over a recent 21-month period through the widespread use of IV disinfection caps, according to a study published in a national medical journal.

In recent years, hospitals across the country have been trying to reduce infections caused by IV lines or catheters threaded directly to the heart. These so-called central line-associated bloodstream infections affect about 250,000 Americans annually. The federal government withholds Medicare reimbursement from hospitals with too many of them.

About 10 years ago, Methodist hospitals in Gary and Merrillville began reducing its central-line infections by instituting evidence-based practices, according to the article published recently in the Journal of the Association for Vascular Access. But infection-control officers realized they hadn’t significantly lowered infections from peripheral lines, which go into veins in the arm and are much more commonly used.

At the time, bedside nurses were required to wipe each IV hub with an alcohol swab and then let it dry. But Methodist found that practically all nurses did this process differently, reducing its efficacy. So the infection control staff solicited the nurses in trying to come up with a solution.

They eventually coalesced around a device called the SwabCap, which continuously bathes the IV hub in alcohol. “Once it’s on, and you leave it on, the IV is protected,” said Mary Jo Valentine, the director of nursing professional development for Methodist Hospitals and a co-author of the study. In December 2011, Methodist began using the cap on all its hubs, systemwide.

Michelle DeVries, senior infection-control officer for Methodist and another of the study’s co-authors, said hospitals have traditionally tracked and reported their numbers of central-line infections. But Methodist had the advantage of having long examined infections on all its lines, she said.

So the hospital system compared the 21-month time period after it started using the disinfection cap to the 21 months prior. It found infections had dropped by 50 percent in central lines, 43 percent in peripheral lines and 45 percent decline overall.

While hospitals tend to focus on central lines because they have a higher overall infection rate, DeVries says that statistic can be deceiving.

“When you look at the numbers for peripheral lines, the rate looks small so it’s easy to diminish the risk,” she said. “But if a small rate is multiplied by 70 percent of patients getting them, the numbers are really important.”

Almost weekly, DeVries speaks about measures like these at infection-control conferences (she recently returned from one in Saudi Arabia). Fellow conference attendees were the ones who encouraged her and her colleagues to publish their findings.

“What we do is great for our patients but by putting it out there in the medical literature, other people can benefit too,” said DeVries, whose other co-author was infection-control colleague Patricia Mancos. “By sharing what we’ve done, other hospitals can think about doing it and make changes too.”