Category: Vascular Access

Wise Foundation Receives Grant from Association for Vascular Access

Posted on by Greg Dennis

One of the pleasures of working in healthcare PR is the opportunity to work with nonprofit organizations. We’ve done this in the fields of breast cancer, prostate cancer and vascular access.

Having worked previously for the Association for Vascular Access (AVA), last year we began supporting the efforts of AVA’s research and education arm, the Wise Foundation.

AVA and the foundation ended the year on a high note, with the announcement of a major grant from AVA to the foundation. The $50,000 grant, given in honor of AVA’s membership, underlines AVA’s support for the foundation’s mission. The grant also strengthens the foundation’s outreach to other major funders.

For more on the grant and the foundation’s work, see Wise Foundation Grant from AVA. Additional info on the foundation and a current grant opportunity available at http://www.wisefoundation.net.

Study ID’s Potent IV Weapon To Prevent Bloodstream Infections

Posted on by Greg Dennis

When one or two hospitals get good results with a new method for preventing infections, it’s “interesting.” When 12 do, it’s time to call the method “important.”

Which is the conclusion Gregory Schears, M.D. of Rochester, Minn. reached about his study of 12 diverse hospitals that trialed SwabCap®, a disinfection cap that is used to passively disinfect the top and threads of needleless IV connectors. Excelsior Medical, SwabCap’s maker, is a Dowling & Dennis client.

Speaking at the annual meeting of the Association for Vascular Access (AVA) – and in a follow-up clinical webinar Dr. Schears said that a disinfection cap should be considered as part of best practice protocols for eliminating central line-associated bloodstream infections (CLABSIs), which kill some 30,000 U.S. patients a year according to the CDC.

You can see Dr. Schears talking about the study here: disinfection cap video. There’s also a free webinar by Dr. Schears that provides more detail on his research, available under “Videos,” here.

How did Dr. Schears reach his conclusions?

Traditionally, nurses disinfect a needleless IV connector manually before accessing the catheter line to draw blood or administer medications or nutrition. The usual method involves scrubbing the connector with an alcohol wipe for 15 seconds, then waiting another 30 seconds for the alcohol to dry before entering the line.

Because the method has several steps, takes at least 45 seconds to do correctly, and often must be done many times a day, busy nurses often cut short the time or skip it entirely. Compliance with 45-second “scrub the hub” protocol is also almost impossible to monitor: What hospital can afford to have someone trail every nurse as she goes about her rounds?

The potential for slip-ups with this method is widely believed to be an obstacle to reaching zero CLABSIs.

The SwabCap disinfection cap, which dispenses alcohol when it is pushed and twisted onto the connectors’ threads, addresses the problems with manual disinfection. It goes on in a few seconds. It twists on just one way, like a lid on a jar, which eliminates variance. Its bright orange color handles the compliance issue, because when it is observed in place, compliance is verified.

It also does two things manual disinfection cannot. Because it creates a seal at the base of the threads, the connector top and threads are continually bathed in alcohol between line accesses. Also, prolonged contact with alcohol is proven to improve disinfection. Moreover, when the cap is in place, it is protecting against touch and airborne contamination.

The hospitals that trialed the disinfection cap in Dr. Schears’ study wanted to test whether it could produce lower CLABSI rates than with manual disinfection alone. The cap’s effectiveness was measured by comparing CLABSI data from the eight-month span prior to the cap’s implementation to the eight months following implementation. This retrospective overview encompassed some 92,000 catheter days – a large number for this kind of study.

The cap made a remarkable difference. The average CLABSI rate reduction at the twelve institutions was 61.6%, which is statistically significant (p<0.0020). The hospitals in the study covered the gamut, from medical to surgical to intensive care in both community hospitals and tertiary care facilities.

For years, a nationwide public-private effort has focused on diminishing CLABSIs, but progress has been spotty. The Schears study suggests that a far greater impact might be achieved if more hospitals adopted disinfection caps. Everything we’ve seen about this device – and the study is just the latest in a constant flow of strong results – points in the same direction.

You can see Dr. Schears talking about the study here: disinfection cap video.

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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.

INS 2011

Posted on by Greg Dennis

The annual meeting of the Infusion Nurses Society attracted hundreds of nurses from all over the  world for  its May gathering in Louisville, Ky.  With Medicare no longer reimbursing for hospital-acquired infections such as  Central-line associated bloodstream infections (CLABSI’s), nurses were especially interested in new technologies to reduce these potential deadly infections.

One of the technologies drawing considerable attention was SwabFlush, from Excelsior Medical (a Dowling & Dennis client). SwabFlush combines the SwabCap disinfection cap for needleless IV Connectors with a flush syringe. More information at www.swabflush.com.

Video of Tony Saia (VP of Global Marketing for Excelsior) demonstrating SwabFlush during INS:

Study Shows Promise of Disinfection Cap as Weapon in the War on Infections

Posted on by Greg Dennis

For years, efforts to reduce central-line associated bloodstream infection (CLABSI) rates have focused on relatively complex initiatives – including “bundles” of evidence-based practices and technologies that together create multi-layered protection against infections. Now, the early results of a prospective, peer-reviewed clinical trial suggest that the use of a simple but ingeniously designed device can contribute to improved disinfection and allow for reduced CLABSIs.

That device – SwabCap® by Excelsior Medical – is also known as a disinfection cap. SwabCap supplements manual disinfection of IV connectors, long thought to be a weak point in CLABSI prevention because the method is subject to variation and noncompliance. The study results were recently reported at the annual meeting of the Society for Healthcare Epidemiology of America (SHEA).

Early results of the prospective, peer-reviewed clinical trial demonstrated that SwabCap® improved disinfection and allowed for reduced central-line associated bloodstream infection rates of more than 79%. Those improvements were seen in the four-hospital NorthShore University HealthSystem (Evanston, Ill.) after SwabCap was implemented for use on all central lines.

Notably, the gains were made even though the hospitals already had a low rate CLABSI rate of 1.95 per 1,000 catheter days before SwabCap was tried.

NorthShore also studied the device’s effectiveness a second way: it compared the density of colony-forming units (CFUs) of bacteria in blood samples when SwabCap was used to CFUs in samples when it wasn’t. During the SwabCap phase of the research, contaminated samples were 75% less dense with bacteria.

The new data is the most extensive ever gathered on SwabCap. The device is in use at multiple institutions, sometimes allowing for a drop in infection rates that is even more dramatic than at NorthShore. More at http://www.swabcap.com.

IV Connectors: Younger Nurses May Be More Diligent Cleaners

Posted on by Greg Dennis

We often think of young people as rebels and their elders as better at following rules. But the opposite is true in American hospitals, a new study says – at least when it comes to disinfecting IV connectors.

Recent graduates of nursing school were more likely “to consistently use optimal disinfection techniques” than were more experienced nurses, according the study, in the May-June issue of the Journal of Infusion Nursing,.

The research examined whether younger or more experienced nurses adhered more closely to the “scrub-the-hub” manual method for disinfecting connectors. The method requires nurses to scrub the connector hubs with alcohol for up to 10-15 seconds and then wait up an additional 30 seconds for the alcohol to dry before accessing the line.

This protocol is widely recommended by infection control experts, but it must be performed meticulously to have any chance of being effective. The method’s several steps mean that variation is common, and busy nurses are known to sometimes skip disinfection altogether. The consequences of variation or noncompliance are great because incomplete disinfection increases the risk for sometimes deadly central line-associated bloodstream infections (CLABSIs).

The study found that nurses just out of school were more likely to perform the protocol exactly as it was taught – a good thing. The more experienced nurses, conversely, rated higher than younger nurses in such qualities as autonomy and “self-efficacy” (essentially, belief in one’s own competence). One can assume from this that more experienced nurses felt more free to stray from the protocol – not a great idea in this case and one that put patients in danger.

The findings may point toward one reason hospitals should be using a disinfection cap such as SwabCap® to supplement manual disinfection. SwabCap, from our client Excelsior Medical, is ingeniously designed to eliminate variation and noncompliance.

By prolonging the hub’s contact with alcohol, it may also increase the bacteria kill over manual methods, especially when compliance with the manual method is not optimal.

Considering what’s at stake, it seems to us that using the cap is a no-brainer – even if a nurse just graduated magna cum laude.

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Vascular Access Group on LinkedIn

Posted on by Greg Dennis

LinkedIn is a tremendous information resource for professionals. But for the most part those in nursing – especially professionals with an interest in infusion therapy and vascular access – have been underrepresented on LinkedIn.

No more! We’ve just established a new forum for vascular access professionals on LinkedIn. It’s open to anyone interested in the field, who wants to read or post about issues and questions pertaining to vascular access.

We hope you’ll consider joining the group. To do so, go to http://www.LinkedIn.com. Join LinkedIn if you are not already a member, then search the “Groups” function for the phrase “vascular access.”

Thanks, and we hope to see you over on LinkedIn soon.

CMS Gets Tough on Infection Reporting

Posted on by Greg Dennis

Ushering in the new year in its own way, the Centers for Medicare and Medicaid Services (CMS) has dropped a hammer on hospitals. A new rule requiring hospitals to report certain central line-associated bloodstream infections (CLABSIs) went into effect last month.

Specifically, the rule states that hospitals must now report the number and rate of adult patients in their intensive care units who get CLABSIs — or the hospitals’ Medicare payments will be reduced by two percent.

We first wrote about this rule in our October 27, 2010 post and you can read the rule’s details there. Part of the rule requires the infection data to be publicly reported on the government’s website, HospitalCompare.hhs.gov. That part of the rule will go into effect later this year.

At Dowling & Dennis, we applaud CMS’ report-or-pay approach. In fact, we think they should carry it a little farther. For instance, the rule only concerns patients in ICUs. We think it should apply hospitalwide.

Even at this point, though, we think this national incentive will be a useful supplement to the patchwork of state reporting laws. There are 27 states that make infection reporting mandatory, with two more that require confidential reporting, and three that have voluntary reporting systems. We expect that the CMS rule will push most hospitals across the country to divulge their infection data.

After all, two percent of Medicare payments is real money.

We’ve learned how important the CLABSI issue is because several of our current or former clients — including Excelsior Medical (SwabCap), Johnson & Johnson (Biopatch), RyMed Technologies (InVision-Plus), and Venetec International (StatLock) – produce medical devices shown to reduce CLABSI risk. Much of our effort the past several years has been to promote the use of these safer technologies.

Where these devices have been implemented, CLABSIs have generally gone down – dramatically. CLABSIs still kill 31,000 U.S. patients per year – in part, because hospitals aren’t adopting such devices fast enough, as many infection control experts have testified.

The CMS rule has several things going for it. For one thing, the data that hospitals report to HospitalCompare will be based on objective, CDC-defined criteria. That isn’t always the case with some state reporting requirements, so that when a consumer compares Hospital A’s infection rate to Hospital B’s, they’re actually comparing apples to oranges. The CMS rule should get us close to apples-to-apples comparisons.

Also, many consumers who have to be hospitalized are likely to go to HospitalCompare to find the safest facilities. You would think all institutions will want a presence in that online system – a presence that includes a low CLABSI rate. This is CMS’s hope, and ours.

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.