Korean J healthc assoc Infect Control Prev.  2019 Jun;24(1):19-25. 10.14192/kjhaicp.2019.24.1.19.

A Comparative Study on the Contamination Level of Intravenous Infusion Ports: A Comparison of 3-way Stopcock (Open-system) and Needleless Connector (Closed-system)

Affiliations
  • 1Department of Nursing, Surgical Intensive Care Unit, Bundang Jesaeng General Hospital, Seongnam, Korea.
  • 2Department of Nursing, Infection Control Office, Bundang Jesaeng General Hospital, Seongnam, Korea. rioriorio@naver.com

Abstract

BACKGROUND
This study was conducted to evaluate the level of intravenous injection port contamination in 3-way stopcock (open-system) or needleless connector (closed-system) intravenous infusion devices before and after disinfecting for 3 seconds with alcohol cotton.
METHODS
Eighty patients who underwent intravenous infusion therapy from April 1, 2018, to June 30, 2018, in a surgical intensive care unit were included. The sampling time was 48 hours after intravenous injection. Patients received 3-way stopcock or needleless connectors in intravenous infusion devices. The device was wiped with alcohol cotton for 3 seconds. Before and after the disinfection of each intravenous infusion port, the intravenous injection port was swapped with a sterile swab. The number of colonies was compared using the blood agar plate medium.
RESULTS
There was a significant difference in the number of colonies between the devices (P=0.001). The number of total colonies was much less in the needleless connectors than in the 3-way stopcock. There was no difference after disinfection of the injection port for 3 seconds, but the number of colonies in the needleless connector was lesser than that in the 3-way stopcock.
CONCLUSION
Needleless connector systems (closed-system) are subject to a lower contamination level than 3-way stopcock systems (open-system). It was confirmed that 3 seconds of disinfection time of the intravenous infusion port is insufficient to decrease bacterial colonization.

Keyword

3-way stopcock; Needleless connector

MeSH Terms

Agar
Colon
Critical Care
Disinfection
Humans
Infusions, Intravenous*
Injections, Intravenous
Agar

Reference

1. Yébenes JC, Vidaur L, Serra-Prat M, Sirvent JM, Batlle J, Motje M, et al. Prevention of catheter-related bloodstream infection in critically ill patients using a disinfectable, needle-free connector: a randomized controlled trial. Am J Infect Control. 2004; 32:291–295.
Article
2. Korean Society for Healthcare-associated Infection Control and Prevention. Infection control and prevention in healthcare facilities. 5th ed. Seoul: Hanmi medical published;2017. p. 256.
3. Hospital Nurses Association. Evidence-based clinical nursing practice guideline: intravenous infusion. Seoul: Hospital Nurses Association;2017. p. 2–70.
4. Zhang L, Cao S, Marsh N, Ray-Barruel G, Flynn J, Larsen E, et al. Infection risks associated with peripheral vascular catheters. J Infect Prev. 2016; 17:207–213.
Article
5. Dolan SA, Arias KM, Felizardo G, Barnes S, Kraska S, Patrick M, et al. APIC position paper: safe injection, infusion, and medication vial practices in health care. Washington, DC: Association for Professionals in Infection Control and Epidemiology;2016. p. 6–8.
6. Marschall J, Mermel LA, Fakih M, Hadaway L, Kallen A, O'Grady NP, et al. Society for Healthcare Epidemiology of America. Strategies to prevent central line-associated bloodstream infections in acute care hospitals: 2014 update. Infect Control Hosp Epidemiol. 2014; 35:753–771.
Article
7. Flynn JM, Keogh SJ, Gavin NC. Sterile v aseptic non-touch technique for needle-less connector care on central venous access devices in a bone marrow transplant population: a comparative study. Eur J Oncol Nurs. 2015; 19:694–700.
Article
8. Royal College of Nursing. Standards for infusion therapy. 4th ed. London: Royal College of Nursing;2016.
9. Infusion Nurses Society:Infusion therapy standards of practice. J Infus Nurs. 2016; 39:S68–S71.
10. Korea Centers for Disease Control and Prevention and Korean Society for Healthcare-associated Infection Control and Prevention. Practical guidelines for infection control in healthcare facilities, Korea. Osong: Korea Centers for Disease Control and Prevention and Korean Society for Healthcare-associated Infection Control and Prevention;2017. p. 75–77.
11. Simmons S, Bryson C, Porter S. “Scrub the hub”: cleaning duration and reduction in bacterial load on central venous catheters. Crit Care Nurs Q. 2011; 34:31–35.
12. Menyhay SZ, Maki DG. Preventing central venous catheter-associated bloodstream infections: development of an antiseptic barrier cap for needleless connectors. Am J Infect Control. 2008; 36:S174.e1–S174.e5.
Article
13. Moureau NL, Flynn J. Disinfection of needleless connector hubs: clinical evidence systematic review. Nurs Res Pract. 2015; 2015:796762.
Article
14. Rundjan L, Rohsiswatmo R, Paramita TN, Oeswadi CA. Closed catheter access system implementation in reducing the bloodstream infection rate in low birth weight preterm infants. Front Pediatr. 2015; 3:20.
Article
15. Casey AL, Worthington T, Lambert PA, Quinn D, Faroqui MH, Elliott TS. A randomized, prospective clinical trial to assess the potential infection risk associated with the PosiFlow needleless connector. J Hosp Infect. 2003; 54:288–293.
Article
16. Park JH. Test report for growth of bacteria. Seoul: Yonsei University;2016.
Full Text Links
  • KJHAICP
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr