Background. Needleless connectors (NC) are used on virtually all intravascular devices, providing an easy access point for infusion\nconnection. Colonization of NC is considered the cause of 50% of postinsertion catheter-related infections. Breaks in aseptic\ntechnique, from failure to disinfect, result in contamination and subsequent biofilm formation within NC and catheters increasing\nthe potential for infection of central and peripheral catheters. Methods.This systematic review evaluated 140 studies and 34 abstracts\non NC disinfection practices, the impact of hub contamination on infection, and measures of education and compliance. Results.\nThe greatest risk for contamination of the catheter after insertion is the NC with 33ââ?¬â??45% contaminated, and compliance with\ndisinfection as low as 10%. The optimal technique or disinfection time has not been identified, although scrubbing with 70%\nalcohol for 5ââ?¬â??60 seconds is recommended. Studies have reported statistically significant results in infection reduction when passive\nalcohol disinfection caps are used (48ââ?¬â??86% reduction). Clinical Implications. It is critical for healthcare facilities and clinicians\nto take responsibility for compliance with basic principles of asepsis compliance, to involve frontline staff in strategies, to facilitate\neducation that promotes understanding of the consequences of failure, and to comply with the standard of care for hub disinfection.
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