Clinician Surveys Help in Fight Against Bloodstream Infections

In a newly published article, a physician suggests that online surveys can help advance two important healthcare-related campaigns -- the national initiative to reduce central line-associated bloodstream infections (CLABSIs); and efforts to protect patients and clinicians from infectious agents in healthcare settings, in part through proper handwashing. The article appears in the spring 2012 issue of the Journal of the Association for Vascular Access (JAVA). 

"These surveys illustrate the strength of this kind of research, because they turned up information that points the way to valuable solutions," says author Gregory Schears, MD, of Rochester, Minn., an anesthesiologist, pediatric intensivist, and physician liaison to the PICC team at his hospital. 

Schears notes that progress against CLABSIs and other infections has been slowed by unsafe behaviors. "Online surveys increase our understanding of the human factors behind these behaviors and can help us devise better strategies -- including technologies that improve compliance with infection-control protocols," he says.

The paper by Schears highlights research showing that nurses blame time pressure as the chief reason that most nurses don't adequately disinfect IV connectors using the "scrub the hub" method. 

As an example of how an online survey can help improve clinical practice, the article described a survey on disinfection of IV needleless connectors. Most of the approximately 600 respondents said nurses usually fail to follow the manual, "scrub the hub" method of disinfecting IV connectors. Seventy-six percent of nurse respondents blamed "rushed for time" as the reason for noncompliance with the traditional, manual method. A substantial majority said they were aware that an isopropyl-alcohol-dispensing device called a disinfection cap could be used to cover and disinfect an IV connector.

"These findings show the usefulness of surveys in several ways," says Schears. "They increase our understanding of the disadvantages of manual disinfection. They also show there is widespread awareness of disinfection caps. That means there is a strong chance these caps can be successfully used in most facilities."

The survey was conducted by Excelsior Medical, Inc., which makes a disinfection cap called SwabCap®.

Another survey in the article questioned interventional radiologists on a range of infection control protocols, including actions that protected patients from CLABSIs and protected the radiologists themselves from potential infections. 

The survey, which had 1,061 respondents, revealed lax behavior in both areas:

- Only 19 percent said they routinely washed their hands between glove applications for central line placement. Hand washing is a fundamental patient safety precaution when inserting central lines. 

- Among other patient safety lapses during central line placement, only 54 percent said they used full-barrier precautions, also a fundamental precaution and one mandated by the CDC to prevent CLABSIs.