Variation in infection prevention practices for peripherally inserted central venous catheters: A survey of neonatal units in England and Wales.
<h4>Background</h4>There is uncertainty about the variation in infection prevention practices for central venous catheters (CVC) in neonatal units (NNUs) and how practices relate to national guidance.<h4>Aim</h4>To evaluate evidence supporting infection prevention practices f...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2018-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0204894 |
| _version_ | 1819110524356395008 |
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| author | Caroline Fraser Katie Harron Laura Dalton Ruth Gilbert Sam J Oddie PREVAIL Study |
| author_facet | Caroline Fraser Katie Harron Laura Dalton Ruth Gilbert Sam J Oddie PREVAIL Study |
| author_sort | Caroline Fraser |
| collection | DOAJ |
| description | <h4>Background</h4>There is uncertainty about the variation in infection prevention practices for central venous catheters (CVC) in neonatal units (NNUs) and how practices relate to national guidance.<h4>Aim</h4>To evaluate evidence supporting infection prevention practices for CVCs recommended in national guidelines and to compare with reported practices for peripherally inserted central catheters (PICC), a type of CVC widely used in NNUs.<h4>Design</h4>We searched national guidelines for neonates and children to identify infection prevention practices for CVCs and conducted an overview of studies to determine the quality of evidence underpinning recommendations. We surveyed 134 NNUs in England and Wales to ascertain reported practice.<h4>Results</h4>We found low quality evidence supporting CVC care bundles and use of 2% alcoholic chlorhexidine to decontaminate catheter ports and skin before insertion. Moderate quality evidence supported recommendations against routinely replacing CVCs and against chlorhexidine-impregnated dressings. 90% (44/49) of NICUs and 40% (34/85) of LNUs responded. 66% (48/73) of NNUs reported using CVC care bundles for insertion; 62% (45/73) used bundles for maintenance. 63% (32/51) of those using bundles reported monitoring adherence. 85% (61/72) of NNUs did not routinely replace PICCs and 89% (63/71) did not use chlorhexidine-impregnated dressings. Antiseptic use varied with alcoholic 2% chlorhexidine used for skin preparation in 33% (23/71) of NNUs and for catheter ports in 52% (37/71).<h4>Conclusions</h4>Lack of consistency across NNUs in antiseptic use and low rates of reported CVC care bundle use may reflect the low quality of evidence of the effectiveness and safety of these interventions in NNUs. Clinical trials are needed to quantify benefits and harms of infection prevention practices in NNUs. |
| first_indexed | 2024-12-22T03:43:05Z |
| format | Article |
| id | doaj.art-77193cb293d74d0b8e937696a033fe6d |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-22T03:43:05Z |
| publishDate | 2018-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-77193cb293d74d0b8e937696a033fe6d2022-12-21T18:40:12ZengPublic Library of Science (PLoS)PLoS ONE1932-62032018-01-011311e020489410.1371/journal.pone.0204894Variation in infection prevention practices for peripherally inserted central venous catheters: A survey of neonatal units in England and Wales.Caroline FraserKatie HarronLaura DaltonRuth GilbertSam J OddiePREVAIL Study<h4>Background</h4>There is uncertainty about the variation in infection prevention practices for central venous catheters (CVC) in neonatal units (NNUs) and how practices relate to national guidance.<h4>Aim</h4>To evaluate evidence supporting infection prevention practices for CVCs recommended in national guidelines and to compare with reported practices for peripherally inserted central catheters (PICC), a type of CVC widely used in NNUs.<h4>Design</h4>We searched national guidelines for neonates and children to identify infection prevention practices for CVCs and conducted an overview of studies to determine the quality of evidence underpinning recommendations. We surveyed 134 NNUs in England and Wales to ascertain reported practice.<h4>Results</h4>We found low quality evidence supporting CVC care bundles and use of 2% alcoholic chlorhexidine to decontaminate catheter ports and skin before insertion. Moderate quality evidence supported recommendations against routinely replacing CVCs and against chlorhexidine-impregnated dressings. 90% (44/49) of NICUs and 40% (34/85) of LNUs responded. 66% (48/73) of NNUs reported using CVC care bundles for insertion; 62% (45/73) used bundles for maintenance. 63% (32/51) of those using bundles reported monitoring adherence. 85% (61/72) of NNUs did not routinely replace PICCs and 89% (63/71) did not use chlorhexidine-impregnated dressings. Antiseptic use varied with alcoholic 2% chlorhexidine used for skin preparation in 33% (23/71) of NNUs and for catheter ports in 52% (37/71).<h4>Conclusions</h4>Lack of consistency across NNUs in antiseptic use and low rates of reported CVC care bundle use may reflect the low quality of evidence of the effectiveness and safety of these interventions in NNUs. Clinical trials are needed to quantify benefits and harms of infection prevention practices in NNUs.https://doi.org/10.1371/journal.pone.0204894 |
| spellingShingle | Caroline Fraser Katie Harron Laura Dalton Ruth Gilbert Sam J Oddie PREVAIL Study Variation in infection prevention practices for peripherally inserted central venous catheters: A survey of neonatal units in England and Wales. PLoS ONE |
| title | Variation in infection prevention practices for peripherally inserted central venous catheters: A survey of neonatal units in England and Wales. |
| title_full | Variation in infection prevention practices for peripherally inserted central venous catheters: A survey of neonatal units in England and Wales. |
| title_fullStr | Variation in infection prevention practices for peripherally inserted central venous catheters: A survey of neonatal units in England and Wales. |
| title_full_unstemmed | Variation in infection prevention practices for peripherally inserted central venous catheters: A survey of neonatal units in England and Wales. |
| title_short | Variation in infection prevention practices for peripherally inserted central venous catheters: A survey of neonatal units in England and Wales. |
| title_sort | variation in infection prevention practices for peripherally inserted central venous catheters a survey of neonatal units in england and wales |
| url | https://doi.org/10.1371/journal.pone.0204894 |
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