Effectiveness of Curos caps

ASHLEY BARMER
KAITLIN DICKEY
CHRISTINE KOSTANSKI
CAROLINE PRICE
MARY WRIGHT

Clinical Problem
Blood stream infections account for 250,000 infections &

more then 30,000 deaths

Increase length of stay, cost, patient morbidity, and mortality

Mortality rates are 12-25 %

Annual cost exceed 2 billion dollars per year
The total estimated cost per hospital is 1 million dollars

per year
In 2010 Joint Commission made a national patient safety
goal to reduce catheter related infections
Healthcare professionals dont use curos caps in an
effective manner
There is not a policy in place for the use of these
(Merrill et al., 2014)

Addressing the Issue

Reduce hospital inquired infections
Save money
Increase compliance of curos caps
Increase patient satisfaction

SMART Goal
Healthcare professionals will use curos caps to

reduce blood stream and hospital acquired infections

on central, PIC, and peripheral lines, and IV tubing
thereby reducing hospital costs and reduce length of
stay whenever the supplies become available for use.
As evidence by decrease length of stay and hospital
acquired infections. Curos caps should be stocked
regularly on all units.

Best Evidence
Methods: Observations on a tertiary care oncology

unit at West Virginia University Hospitals

Intervention: This unit went from using alcohol
wipes to alcohol impregnated caps from January to
July 2010.
Results:

Intervention: 3005 central line days and 1 CLABSI

Control: 6851 central line days 16 CLABSI
Decrease in infection from 2.5% to 0.2%

(Sweet et al., 2012)

Best Evidence
Methods: Used state space model to look at the flow of

admissions through ICUs and followed the state of

patients from admission to death or discharge. The state
of the patient quantifies the effect of the closed system.
For example: A patient with a central line who doesnt
acquire an infection and then disharged vs a patient
with a central line that acquires infection and dies,
Interventions: State space model treats infection open
versus caped IV ports
Results: Closed IV systems reduced CLABSIs infection
rate and deaths related to them.

Current Practice in Bon Secours

MRMC does not use the curos caps due to the

nursing staff being told that the are too expensive

MRMC does not keep them stocked in the server
rooms therefore it is not convenient for the nursing
staff.
There is no policy or mandatory requirement to use
curos caps with in Bon Secours.

Practice, Product, Process

Practice/Process:

Nurses use caps on all open ports whether it be central, PICC,

peripheral lines, and IV tubing.
Mandatory charting on using alcohol caps

Product:

Collaborate with materials management to get curos caps

Have representative come from curos and do and in-service for
the staff
Stock curos caps in the room

Potential Barriers and Facilitators to Proposed Change

Barriers:

Resistance to change
Not having the curos caps on the unit/or easily accessible
Lack of knowledge
Expense
Since there is no policy

Facilitators

Have PCTs stock the caps on the IV poles or in the rooms

Have materials management put the curos caps next too IV
supplies
Have managers, charge nurses, and clinical coordinators
encourage compliance

Financial Implications of Using

Caps
SAVED ONE HOSPITAL $300,000 IN A YEAR
SAVING ON MEDICATION USE AND HOSPITAL STAYS (LABS AND
TESTS)
TOTAL ESITMATED COST OF CLABSIS BEFORE CAPS WERE
IMPLEMENTED WAS 1 MILLION, AFTER IMPLEMENTATION THE COST
OF CLABSIS $575,000
AFTER SUBTRACTING PRODUCT COST THE TOTAL SAVINGS WAS
$282,840
DECREASED 86 DAYS OF HOSPITAL STAYS AND PREVENTED ONE
DEATH
CITE MERILL

References
Merrill, K., Sumner, S., Linford, L., Taylor, C., & Macintosh, C. (2014).
Impact
of universal disinfectant cap implementation on central lineassociated bloodstream infections. American Journal of Infection
Control, 42, 1274-1277.
S w e e t , M . , C r u m p s t o n , A. , B r i g g s , F., C r a i g , M . , & H a m a d a n i , M . ( 2 0 1 2 ) .
Impact of alcohol-impregnated port protectors and needleless
neutral
pressure connectors on central-line associated bloodstream infections and
contamination of blood cultures in an inpatient oncology unit. American
journal of Infection Control 40, 931-934.
DOI: 10.1016/j.ajic.2012.01.25