Impact of sterile gloving during proximal manipulation of central line catheter hub: the multicenter observational study CleanHandPROX.
Humans
Catheter-Related Infections
/ prevention & control
Catheterization, Central Venous
/ adverse effects
Health Personnel
Gloves, Surgical
/ microbiology
Central Venous Catheters
/ microbiology
France
Equipment Contamination
/ prevention & control
Gloves, Protective
Guideline Adherence
Cross Infection
/ prevention & control
Infection Control
/ methods
Female
Male
Asepsis
Central lines
Central venous catheter
Implantable catheter ports
Improvement of practices
Peripherally inserted central catheter
Proximal manipulation
Sterile gloving
Journal
Antimicrobial resistance and infection control
ISSN: 2047-2994
Titre abrégé: Antimicrob Resist Infect Control
Pays: England
ID NLM: 101585411
Informations de publication
Date de publication:
06 Oct 2024
06 Oct 2024
Historique:
received:
13
06
2024
accepted:
14
09
2024
medline:
7
10
2024
pubmed:
7
10
2024
entrez:
6
10
2024
Statut:
epublish
Résumé
Patients with central lines face an increased risk of developing bacteremia. Preventing late-onset catheter-related infections relies on implementing various measures during manipulations of the catheter hub of central lines (e.g., during connections, disconnections, blood withdrawals, pulsed rinses, or injections performed at the first connection after the central catheter). French guidelines include, among these measures, the requirement to put on sterile gloves immediately before proximal manipulation to help prevent contamination of the catheter hub during preparation. To our knowledge, no study has reported compliance with wearing sterile gloves during these manipulations, nor the impact of not wearing sterile gloves on the cleanliness of the fingers of healthcare workers (HCWs) just before manipulating the connectors. We conducted a two-part study to assess compliance with sterile gloving and to provide direct microbiological evidence of bacterial contamination on HCWs' hands immediately before the manipulation of central lines when sterile gloving is not used. First, the use of sterile gloves was observed during proximal manipulations of central lines using a standardized grid. Second, we examined the microbial flora present on the fingers of each observed HCW just before proximal manipulation. A total of 260 HCWs from 35 healthcare institutions were observed during proximal manipulation. The HCWs were distributed into three groups: 188 used sterile gloves (72%), 23 used nonsterile gloves (9%), and 49 did not wear gloves (19%). The swabbing of the fingertips revealed microbial cultures from 72 samples (28%). A total of 97 microorganisms were identified, all of which are well-recognized agents responsible for catheter-related bacteremia, predominantly coagulase-negative staphylococci (n = 36) and Bacillus sp. (n = 31). Fingertip contamination was lower for HCWs wearing sterile gloves (27/188; 14%) than for those wearing nonsterile gloves (12/23; 52%) or not wearing gloves (33/49; 67%) (p < 0.001). The contaminants were similar across the three groups. Our data support the positive impact of sterile gloving in ensuring clean fingertips during proximal manipulation of central lines, a key measure in preventing late-onset catheter-related bacteremia. The contamination of sterile gloves in one out of seven HCWs highlights the need for a clean care environment and minimal contact with the patient's skin and surroundings during proximal manipulation.
Sections du résumé
BACKGROUND
BACKGROUND
Patients with central lines face an increased risk of developing bacteremia. Preventing late-onset catheter-related infections relies on implementing various measures during manipulations of the catheter hub of central lines (e.g., during connections, disconnections, blood withdrawals, pulsed rinses, or injections performed at the first connection after the central catheter). French guidelines include, among these measures, the requirement to put on sterile gloves immediately before proximal manipulation to help prevent contamination of the catheter hub during preparation. To our knowledge, no study has reported compliance with wearing sterile gloves during these manipulations, nor the impact of not wearing sterile gloves on the cleanliness of the fingers of healthcare workers (HCWs) just before manipulating the connectors.
METHODS
METHODS
We conducted a two-part study to assess compliance with sterile gloving and to provide direct microbiological evidence of bacterial contamination on HCWs' hands immediately before the manipulation of central lines when sterile gloving is not used. First, the use of sterile gloves was observed during proximal manipulations of central lines using a standardized grid. Second, we examined the microbial flora present on the fingers of each observed HCW just before proximal manipulation.
RESULTS
RESULTS
A total of 260 HCWs from 35 healthcare institutions were observed during proximal manipulation. The HCWs were distributed into three groups: 188 used sterile gloves (72%), 23 used nonsterile gloves (9%), and 49 did not wear gloves (19%). The swabbing of the fingertips revealed microbial cultures from 72 samples (28%). A total of 97 microorganisms were identified, all of which are well-recognized agents responsible for catheter-related bacteremia, predominantly coagulase-negative staphylococci (n = 36) and Bacillus sp. (n = 31). Fingertip contamination was lower for HCWs wearing sterile gloves (27/188; 14%) than for those wearing nonsterile gloves (12/23; 52%) or not wearing gloves (33/49; 67%) (p < 0.001). The contaminants were similar across the three groups.
CONCLUSIONS
CONCLUSIONS
Our data support the positive impact of sterile gloving in ensuring clean fingertips during proximal manipulation of central lines, a key measure in preventing late-onset catheter-related bacteremia. The contamination of sterile gloves in one out of seven HCWs highlights the need for a clean care environment and minimal contact with the patient's skin and surroundings during proximal manipulation.
Identifiants
pubmed: 39370526
doi: 10.1186/s13756-024-01467-5
pii: 10.1186/s13756-024-01467-5
doi:
Types de publication
Journal Article
Multicenter Study
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
117Investigateurs
Alexandra Allaire
(A)
Sophie Allemon-Dewulf
(S)
Amina Azzam
(A)
Frédéric Barbut
(F)
Magali Bauer
(M)
Virginie Bayon
(V)
Laetitia Bernadou
(L)
Bénédicte Bogard
(B)
Sundy Bordelais
(S)
Laetitia Borrelys
(L)
Cécile Bourgain
(C)
Céline Chatelet
(C)
Lydia Decruyenaere
(L)
Peggy Delavault
(P)
Claudia Douat-Beyries
(C)
Julie Douay
(J)
Marlène Ducasse-Mege
(M)
Fatia El-Boundri
(F)
Elisabeth Fino
(E)
Clotilde Groleau
(C)
Christelle Guillard
(C)
Danielle Jaafar
(D)
Emmanuelle Joseph
(E)
Gratienne Laethem
(G)
Adeline Ledez
(A)
Florence Malfondet
(F)
Nadine Mertel
(N)
Nadine Negrin
(N)
Anne Perez
(A)
Aline Prenant
(A)
Morgane Valsaque
(M)
Marie-Christine Gadras
(MC)
Informations de copyright
© 2024. The Author(s).
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