Hub Cleansing to Prevent Hub Infection

NCT ID: NCT01563406

Last Updated: 2016-04-18

Study Results

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Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

149 participants

Study Classification

INTERVENTIONAL

Study Start Date

2012-03-31

Study Completion Date

2013-06-30

Brief Summary

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Central venous catheter infections are common preventable adverse events among hospital patients. Microbes may enter catheter hubs, also known as needleless connectors, and result in downstream contamination. This study aims to compare alcohol disinfection of catheter hubs to disinfection with chlorhexidine gluconate in alcohol, which has been proven to be a superior disinfectant at the site of central venous catheter insertion. Scrub duration of central venous catheter hubs will also be evaluated.

Detailed Description

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A prospective randomized blinded crossover clinical trial will be performed in the medical intensive care unit at Rush University Medical Center. The intensive care unit will be divided into two regions (A\&B). Hub disinfectants and duration of disinfection will be randomly assigned to these regions. After 1/2 of the study period, the agents will crossover, but the duration of scrubbing will remain the same, analogous to a 2 by 2 factorial design. Our primary endpoint will be internal contamination of hubs and catheters.

In February 2012 it was determined that the supplier of chlorhexidine and alcohol pads could not completely blind each pad. It was decided that a plain white sticker would be affixed to the front of each pad, but the safety information on the back of each pad would remain visible.

3/27/12-Internal hub contamination (yes/no)was clarified as the primary outcome.

On 5/10/12 a new sample size calculation adjusted the hub sample size needed to power the main effects based on more accurate information regarding the expected hub contamination rate. The expected hub contamination rate changed because of the more sensitive hub culture method that was adopted before the study began. This more sensitive method also allowed for a new secondary outcome of number of microbial colony forming units per hub.

The first crossover time selected was 6/11/12, prior to the midpoint of the study. This was done to try to improve a large imbalance in the group sizes.

On 6/11/12 a hold was placed on the catheter tip component of the study, because of an inability to collect tips.

On 8/7/12 the catheter tip outcome was dropped because of an inability to collect tips.

On 1/11/13 a second crossover was implemented in an effort to balance the sizes of the study groups.

Conditions

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Bacteremia

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

FACTORIAL

Primary Study Purpose

PREVENTION

Blinding Strategy

DOUBLE

Participants Caregivers

Study Groups

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Alcohol with 5 second scrub

70% isopropyl alcohol will be used to scrub catheter hubs for a duration of 5 seconds.

Group Type EXPERIMENTAL

5 second scrub

Intervention Type OTHER

Scrub catheter hubs for 15 seconds before every access.

70% isopropyl alcohol

Intervention Type DRUG

70% isopropyl alcohol pads will be used to disinfect catheter hubs prior to accessing central venous catheters for the other half of the study period.

Alcohol with 15 second scrub

70% isopropyl alcohol will be used to scrub catheter hubs for a duration of 15 seconds.

Group Type EXPERIMENTAL

15 second scrub

Intervention Type OTHER

Scrub catheter hubs for 15 seconds before every access.

70% isopropyl alcohol

Intervention Type DRUG

70% isopropyl alcohol pads will be used to disinfect catheter hubs prior to accessing central venous catheters for the other half of the study period.

Chlorhexidine with 5 second scrub

3.15% chlorhexidine/70% isopropyl alcohol will be used to scrub catheter hubs for a duration of 5 seconds.

Group Type EXPERIMENTAL

5 second scrub

Intervention Type OTHER

Scrub catheter hubs for 15 seconds before every access.

3.15% chlorhexidine/70% isopropyl alcohol

Intervention Type DRUG

3.15% chlorhexidine gluconate in 70% isopropyl alcohol pads will be used to disinfect catheter hubs prior to accessing central venous catheters during half of the study period.

Chlorhexidine with 15 second scrub

3.15% chlorhexidine/70% isopropyl alcohol will be used to scrub catheter hubs for a duration of 15 seconds.

Group Type EXPERIMENTAL

15 second scrub

Intervention Type OTHER

Scrub catheter hubs for 15 seconds before every access.

3.15% chlorhexidine/70% isopropyl alcohol

Intervention Type DRUG

3.15% chlorhexidine gluconate in 70% isopropyl alcohol pads will be used to disinfect catheter hubs prior to accessing central venous catheters during half of the study period.

Interventions

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15 second scrub

Scrub catheter hubs for 15 seconds before every access.

Intervention Type OTHER

5 second scrub

Scrub catheter hubs for 15 seconds before every access.

Intervention Type OTHER

3.15% chlorhexidine/70% isopropyl alcohol

3.15% chlorhexidine gluconate in 70% isopropyl alcohol pads will be used to disinfect catheter hubs prior to accessing central venous catheters during half of the study period.

Intervention Type DRUG

70% isopropyl alcohol

70% isopropyl alcohol pads will be used to disinfect catheter hubs prior to accessing central venous catheters for the other half of the study period.

Intervention Type DRUG

Other Intervention Names

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Professional Disposables International Inc. Chlorascrub Swab Professional Disposable International Inc Alcohol Prep Pad

Eligibility Criteria

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Inclusion Criteria

* Medical intensive care unit patients with non-tunneled central venous catheters

Exclusion Criteria

* Dialysis catheters
* Antibiotic-impregnated catheters
* Introducer sheaths
* Tunneled catheters
Minimum Eligible Age

16 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Centers for Disease Control and Prevention

FED

Sponsor Role collaborator

Rush University Medical Center

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Mary K Hayden, MD

Role: PRINCIPAL_INVESTIGATOR

Rush University Medical Center

Robert A Weinstein, MD

Role: PRINCIPAL_INVESTIGATOR

Cook County Health and Hospital Systems

Locations

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Rush University Medical Center

Chicago, Illinois, United States

Site Status

Countries

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United States

Other Identifiers

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U54CK000161-01W1

Identifier Type: NIH

Identifier Source: org_study_id

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