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A Successful Approach to Reducing Bloodstream Infections Based on a Disinfection Device for Intravenous Needleless Connector Hubs

Stango, Claire RN, CIC; Runyan, Debra BS, MT (ASCP), CIC; Stern, John MD; Macri, Ida BSN, RN, CIC; Vacca, Maria BSN, RN, CIC, PCCN

doi: 10.1097/NAN.0000000000000075

When central line-associated bloodstream infections (CLABSIs) spiked in an oncology unit of an acute care hospital in Philadelphia from October 2009 to March 2010, noncompliance with intravenous needleless connector disinfection was suspected as a factor. The hospital implemented a disinfection cap, a device designed to address compliance/variance issues with connector disinfection protocols. However, the incidence of CLABSIs increased again in 1 unit, apparently as the result of poor compliance with cap use. The hospital addressed the problem with multiple measures, after which the incidence of CLABSIs again continued to decline. Overall, 50% fewer CLABSIs occurred in the first 21 months after cap implementation. Potential net financial savings from cap use were calculated to be $464 440 a year. (See Abstract Video, Supplemental Digital Content 1,

Supplemental Digital Content is Available in the Text.

Pennsylvania Hospital, Philadelphia, Pennsylvania.

Claire Stango, RN, CIC, is an infection preventionist at Pennsylvania Hospital, a 520-bed, acute care institution in Philadelphia, which is part of the University of Pennsylvania Health System.

Debra Runyan, BS, MT (ASCP), CIC, is the director of the Infection Prevention Department at Pennsylvania Hospital.

John Stern, MD, is chief of Pennsylvania Hospital's Division of Infectious Diseases.

Ida Macri, BSN, RN, CIC, is an infection preventionist at Pennsylvania Hospital.

Maria Vacca, BSN, RN, CIC, PCCN, is an infection preventionist at Pennsylvania Hospital.

Corresponding Author: Claire Stango, RN, CIC, Pennsylvania Hospital, Pine Basement, 800 Spruce Street, Philadelphia, PA 19107 (

The authors of this article have no conflicts of interest to disclose.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text, and links to the digital files are provided in the HTML text of this article on the journal's Web site (

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