Antiseptic barrier cap effective in reducing central line-associated bloodstream infections: A systematic review and meta-analysis. (April 2017)

• Record Type: Journal Article
• Authors: Voor in 't holt, Anne F.; Helder, Onno K.; Vos, Margreet C.; Schafthuizen, Laura; Sülz, Sandra; van den Hoogen, Agnes; Ista, Erwin
• Is Part Of: International journal of nursing studies. Volume 69(2017)
• Page Start: 34
• Page End: 40
• Publication Date: 2017-04
• Subjects: Antiseptic barrier cap -- Central line-associated bloodstream infections -- Infection control -- Meta-analysis -- Systematic review; Nursing -- Periodicals; Nursing -- Periodicals; Soins infirmiers -- Périodiques; Nursing; Periodicals; 610.73
• DOI: 10.1016/j.ijnurstu.2017.01.007
• Languages: English
• ISSNs: 0020-7489

Abstract

Abstract: Background: Microorganisms can intraluminally access a central venous catheter via the catheter hub. The catheter hub should be appropriately disinfected to prevent central line-associated bloodstream infections (CLABSIs). However, compliance with the time-consuming manual disinfection process is low. An alternative is the use of an antiseptic barrier cap, which cleans the catheter hub by continuous passive disinfection. Objective: To compare the effects of antiseptic barrier cap use and manual disinfection on the incidence of CLABSIs. Design: Systematic review and meta-analysis. Methods: We systematically searched Embase, Medline Ovid, Web-of-science, CINAHL EBSCO, Cochrane Library, PubMed Publisher and Google Scholar until May 10, 2016. The primary outcome, reduction in CLABSIs per 1000 catheter-days, expressed as an incidence rate ratio (IRR), was analyzed with a random effects meta-analysis. Studies were included if 1) conducted in a hospital setting, 2) used antiseptic barrier caps on hubs of central lines with access to the bloodstream and 3) reported the number of CLABSIs per 1000 catheter-days when using the barrier cap and when using manual disinfection. Results: A total of 1537 articles were identified as potentially relevant and after exclusion of duplicates, 953 articles were screened based on title and abstract; 18 articles were read full text. Eventually, nine studies were included in the systematic review, and seven of these nine in the random effects meta-analysis. The pooled IRR showed that use of the antiseptic barrier cap was effective in reducing CLABSIs (IRR = 0.59, 95% CI = 0.45–0.77, P < 0.001). Conclusions: Use of an antiseptic barrier cap is associated with a lower incidence CLABSIs and is an intervention worth adding to central-line maintenance bundles.