Disinfection caps are included in new recommendations from infection control organizations

The use of disinfection caps is included in major new infection-control recommendations sponsored by the Society for Healthcare Epidemiology of America (SHEA) and other top infection-control organizations.

The practice recommendations mark the first time that disinfection caps have been included in a leading set of guidelines for hospitals. It is also the first time that the benefits of using disinfection caps have achieved this degree of recognition from a panel of the nation's leading infection-control experts. Disinfection caps cover, protect and disinfect IV needleless connectors, which are also known as hubs, ports or valves.

The recommendations, published in the journal Infection Control and Hospital Epidemiology (ICHE), include the use of “an antiseptic-containing hub/connector cap/port protector to cover connectors” when a hospital has an unacceptable rate of central line-associated bloodstream infections (CLABSIs) after implementing basic prevention strategies. The SHEA authors placed the quality of evidence to support the use of disinfection caps in Category I, which is the highest ranking possible in the document.

The standard “scrub the hub” method traditionally used to disinfect IV needleless connectors is also included in the SHEA document, though the paper raises a question about the length of time required to scrub. The recommendations also encourage hospitals to “monitor compliance with hub/connector/port disinfection, since approximately half of such catheter components are colonized under conditions of standard practice.”

In addition to using disinfection caps with central venous catheters, a growing number of hospitals also apply disinfection caps on needleless connectors for peripheral IV lines. The SHEA document notes that other kinds of catheters such as peripheral IVs are “associated with risk of bloodstream infection” and adds, “Future surveillance systems may need to include bloodstream infections associated with these types of catheters.” Read the recommendations.