Category: Catheter Infections

Patient Safety and Educating IV Nurses

Posted on by Greg Dennis

As nurses have more demands placed on them to ensure patient safety, effective tools for educating nurses become increasingly important.

After all, how can we expect nurses to handle sophisticated technology in the most effective way, if we don’t do a good job of teaching them and involving them in the learning process?

One new tool for that educational process, when it comes to vascular access and infusion therapy, is an infographic recently presented as a scientific poster at the annual conference of the Association of Professionals in Infection Control and Epidemiology (APIC).

You can view a brief video about the infographic — which features a disinfection cap for protecting needleless IV connectors from contamination — on the PICC Excellence website of presenter Nancy Moureau, RN, BSN, CRNI, CPUI, here.

Contaminated Alcohol Swabs: One More Reason to Use Disinfection Cap

Posted on by Greg Dennis

There were already real concerns about the use of alcohol swabs to disinfect needleless IV connectors. Now here comes another one: The pads themselves can be a source of potentially deadly contamination.

The FDA announced Jan. 5 that Triad Group, a Hartland, Wis. manufacturer, was voluntarily recalling all lots of its alcohol prep pads, alcohol swabs, and alcohol swab sticks because they might be contaminated with the organism Bacillus cereus. Use of any of these products, if contaminated, “could lead to life-threatening infections, especially in at-risk populations, including immune-suppressed and surgical patients,” the FDA’s press release said.

Triad products are widely used in the healthcare marketplace, not just under the Triad name but also as private-labeled products for corporate customers. In addition, various companies include them in their medical product packages – which is why corporations such as Bayer and Genentech are informing their customers about the recall and warning them not to use the Triad alcohol products packaged with their medicines.

Even before this brouhaha, many infection control professionals worried about the use of alcohol swabs to disinfect IV connectors. Hospitals generally require that connectors be disinfected before a clinician accesses an IV line for a blood draw or to inject nutrients or medication. The traditional method involves scrubbing the port with an alcohol swab for 10-15 seconds and then waiting for the alcohol to dry before accessing the line.

Even if the swabs are sterile, this somewhat complicated, time-consuming method is prone to variance and noncompliance, which increases the chances of a potentially fatal bloodstream infection.

“Alcohol prep pads are only as good as the person using them. Prep pads are rarely used long enough or with enough friction to cover all surface areas,” says Nancy Moureau, vascular access specialist with PICC Excellence (Hartwell, Ga.)

The best way to avoid the pitfalls of alcohol scrubbing – not to mention contaminated swabs – is to use a disinfection cap such as SwabCap (Excelsior Medical, a client of Dowling & Dennis). SwabCap twists onto the threads of the connector. Its patent-pending design keeps the entire port bathed in alcohol, an ideal disinfection scenario.

Because it is left on between line accesses, it also protects against contamination of the port during that time, something that even meticulous scrubbing can’t do. Variation in technique – a recognized source of infection risk with alcohol pads — is virtually impossible, because the cap twists on one way, like a nut onto a bolt. Compliance is simple to verify. If the bright orange cap is attached to the port, compliance has occurred. No wonder we’ve seen bloodstream infection rates plummet at one hospital after another when they adopt the device.

Hospitals that use alcohol swabs to scrub connectors are busy emptying their shelves of Triad alcohol products if they stocked them. But they still have to fret about variation in technique, noncompliance with the alcohol-pad protocol, and contamination between line accesses.

Hospitals that use disinfection caps like SwabCap, by comparison, know they have an extra measure of protection and disinfection.

New CMS Rule on Infection Reporting

Posted on by Greg Dennis

If hospitals see more revenue from the Centers for Medicare and Medicaid Services (CMS) next year, they may owe a thank-you to the Society for Healthcare Epidemiology of America (SHEA) – and their own infection prevention pros.

SHEA is urging infection control professionals to get up to speed on new CMS requirements for reporting central line-associated bloodstream infections (CLABSIs). Starting in 2011, CLABSIs and certain other healthcare-acquired infections (HAIs) will have to be reported on the CDC’s National Healthcare Safety Network (NHSN) for hospitals participating in the CMS Hospital Inpatient Quality Reporting Program. Participation in the programs is voluntary but here’s the catch: Hospitals can’t get full CMS payment without taking part.

How does the process work? Hospitals report their CLABSI data from their adult and pediatric intensive care units and neonatal intensive care units to NHSN, which then shares it with CMS.

Each facility’s data will be also be uploaded to CMS’s Hospital Compare tool, which is designed to publicly report hospital performance so it can be usefully compared.

The focus on CLABSI data will benefit patients will also live in the value of industry’s contributions to preventing infections. Included in the latter, among companies with which we work, are Excelsior Medical and RyMed.

The partnership between CMS and NHSN is intended to create greater transparency of HAI data, make hospitals more accountable for quality care, and boost facility’s support for infection prevention programs and professionals. Read more about NHSN here: http://www.cdc.gov/nhsn/cms-welcome.html/ .

IV Journal Launches, on the Cutting Edge

Posted on by Greg Dennis

Here’s further evidence that vascular access and infection control remain cutting-edge efforts in medicine.

At a time that is witnessing the death of many publications, including several in the healthcare trade media, a new publication covering intravenous care has been launched. Rather than tie itself down to the old paper-publication model, the new IV Journal is online only.

But happily, publisher Andrew Jackson, out of Britain, has created a journal that uses the best of online technology and is also visually appealing. News of the launch can be found here: http://www.ivteam.com/iv-journal-launched. He’s also drawing on contributors internationally.

Here’s how Jackson describes IV Journal:

“This intrepid, innovative new publication acknowledges the rapidly changing nature of intravenous care. Traditional paper based publications are usually bound by subscription restrictions. Intravenous Journal wants to provide a subscription-free online format to provide any IV professional with a unique IV journal experience.”

It’s also worth noting that Jackson publishes the very useful electronic newsletter, IV Team. More about that at http://www.ivteam.com.

AVA Conference Highlights CRBSI

Posted on by Greg Dennis

We’ve recently returned from the very successful annual meeting of the Association for Vascular Access (www.avainfo.org). Though many hospitals have reduced the size of their IV teams or eliminated them altogether, it was obvious from last week’s gathering at the gigantic Gaylord conference center in National Harbor, Md. that there is still a substantial cohort of vascular access experts out there, working hard and deeply committed to better patient care.

One of the highlights of the conference for us was doing a focus group with Excelsior Medical, makers of the SwabCap disinfection cap for needleless IV connectors. Excelsior took the time and effort to meet with a small group of nurses to get some qualitative, very informative feedback about the vascular access challenges that nurses face.

Earlier in the month, Excelsior also teamed with AVA to cosponsor a webinar on best methods to disinfect needless connectors. The webinar is archived at http://tinyurl.com/35c6jnt.

The focus group and other feedback indicate that hospitals and vascular access nurses remain open to new and better means to achieve two goals:

1.) Complying with Joint Commission and similar protocols for cleaning needleless connectors/disinfection caps.

2.) Reducing catheter-related bloodstream infections (CRBSI, also known as a central line associated bloodstream infections or CLABSI).

Watch this space for more about the AVA conference and other new technological developments featured at the conference.

FDA Scrutinizes Medical Device Companies

Posted on by Greg Dennis

Anybody involved in the medical device industry can’t help but notice how much bigger a presence the FDA is these days.

Within the past month, the agency has taken two notable actions with regard to vascular access and infection control — areas of particular concern to clinicians and companies, including several of our coalition partners and client companies.

Most recently, the FDA has issued a recall of certain Huber needles used for vascular access. The needles, the agency said, could produce cores — slivers of silicone — when they penetrate a vascular access port. That could lead to infection and other complications. More info at http://tinyurl.com/2v4k9kw.

Even more significantly, earlier this month the agency notified virtually every maker of needleless IV connectors that they would have to do major post-market studies to determine if their positive-pressure needleless IV connectors were associated with an increased risk of potentially deadly catheter related bloodstream infections (CRBSI).

Interestingly, it appears that the only maker of needleless IV connectors NOT affected by the recall was RyMed Technologies, which makes only neutral-pressure (AKA zero-displacement) connectors. (Full disclosure: RyMed is one of our clients.)

More about that FDA action on connectors at http://tinyurl.com/3az47ko.

And of course, beyond these actions, every regulatory person in the medical device industry has a story to tell about increased FDA scrutiny of device applications for marketing clearance.

The WAND Continues to Draw a Crowd

Posted on by Greg Dennis

Among the most crowded booths at the recent annual meeting of the Association for Vascular Access was that of Access Scientific, makers of The WAND, which enables the Accelerated Seldinger Technique. This faster and safer means of placing central line catheters is expected to be available late this year, from Access Scientific.

Nurses often lined up two rows deep to see The WAND demonstrated by Dr. Steve Bierman, the Access CEO, and by VP Bill Bold. The WAND is designed to eliminate many of the risks associated with the widely used Modified Seldinger Technique. Risks of MST include accidental needlesticks, bleeding, contamination, embolism, and loss of cannulation.

Also at AVA, Access Scientific and Teleflex teamed to provide the first Nurse Certificate Program in the Accelerated Seldinger Technique.

Continue reading “The WAND Continues to Draw a Crowd” →

Joint Commission Will Require Catheter Valve Disinfection

Posted on by Greg Dennis

The Joint Commission will require hospitals to have a standardized protocol to disinfect catheter luer access valves, starting January 2010. In the face of that new dictum, what’s a hospital to do?

A panel pondering that question – and featuring three national vascular access experts — drew more than 100 nurses at the recent annual meeting of the Association for Vascular Access. Panelists were:

• Lynn Hadaway, M.Ed., RNC, CRNI, infusion therapy expert
• Gregory Schears, MD, Mayo Clinic
• Kelly Fugate, ND, RN, Joint Commission

The panel’s focus: Preventing Intraluminal Contamination from CRBSI’s: Complying with New Guidelines from the Joint Commission & SHEA Compendium.” The event was sponsored by Excelsior Medical, makers of the SwabCap disinfection cap for luer access valves, and moderated by Greg Dennis, of Dowling & Dennis Public Relations.

Dr. Schears led off by outlining the seriousness of catheter-related bloodstream infections, which are all too common despite years of effort aimed at eradicating these potential killers. He said it was a “logical extension” of infection control efforts to cover and disinfect valves with a cap.

Lynn Hadaway outlined a variety of studies on the issue, while Kelly Fugate explained why the Joint Commission has new National Patient Safety Goals that include the disinfection protocol requirement,..

For more on SwabCap, go to http://www.Excelsiormedical.com. Excelsior Medical is a client of Dowling & Dennis Public Relations.

Excelsior, Novian Added as New Clients

Posted on by Greg Dennis

We’re happy to report that even in the economic downturn, we’ve added two new clients:

* Excelsior Medical is a leading maker of prefilled catheter flush syringes. The company is also launching an exciting new technology called SwabCap™. This product promises to pioneer more effective prevention of potentially deadly catheter-related bloodstream infections.

SwabCap provides passive, verifiable disinfection of the top and threads of luer access valves. These valves are a critical part of providing IV medication and nutrition. Both the Joint Commission and SHEA/IDSA Compendium have new guidelines calling for hospitals to have a specific disinfection protocol– meaning Excelsior expects strong demand for SwabCap as part of the company’s focus on preventing intra-luminal contamination of catheters. http://www.ExcelsiorMedical.com

*Novian Health makes the Novilase™ laser ablation device to treat fibroadenomas of the breast. These non-cancerous lumps are a troubling breast health problem for many women. Novilase provides a minimally invasive alternative to surgical lumpectomy, with no scarring and less infection risk. Novilase is FDA-cleared for treating fibroadenomas. http://novianhealth.com