title: Infection rates in intensive care units by electrocardiographic lead wire type: disposable vs reusable.
abstract: BACKGROUND
  It is unknown if disposable electrocardiographic lead wires (ECG-LWs) reduce infection rates compared with cleaned, reusable lead wires.
  
  
  OBJECTIVE
  To compare infection rates in intensive care unit (ICU) patients receiving disposable versus reusable ECG-LWs.
  
  
  METHODS
  Matched adult ICUs were randomly assigned to disposable or reusable ECG-LWs. Outcomes were bloodstream infection, ventilator-associated pneumonia, and chest surgical site infections. Patients' characteristics and infections were collected from hospital databases. Event rates were described by using total counts and rates per 100 patient days and were compared between groups by using generalized linear mixed-effect models weighted by patients' ICU length of stay.
  
  
  RESULTS
  Overall, 4056 patients from 6 ICUs received disposable and 3184 patients from 5 ICUs received reusable ECG-LWs. The characteristics of the 2 groups were similar, except patients receiving disposable ECG-LWs were less likely to be discharged home (P = .03) and had more comorbid conditions (P = .002). Overall infection rates did not differ between ECG-LW groups, between groups in matched ICUs, between groups by infection type, or when only patients with ICU stays longer than 48 hours were considered (2578 cases). In multivariate analyses, infection rates did not differ between all patients in ECG-LW groups or for patients with ICU stays beyond 48 hours (both P = .10).
  
  
  CONCLUSIONS
  No difference was observed in infection rates of ICU patients receiving disposable versus reusable ECG-LWs.
authors.affiliation: Nancy M. Albert is the associate chief nursing officer, Office of Research and Innovation-Nursing Institute and a clinical nurse specialist, Kaufman Center for Heart Failure-Heart and Vascular Institute at Cleveland Clinic in Cleveland, Ohio. She is also an adjunct professor at Aalborg University in Aalborg, Denmark, and an adjunct associate professor at Case Western Reserve University, Francis Payne Bolton School of Nursing in Cleveland, Ohio. Ellen Slifcak is a research nurse, Joel D. Roach is a research coordinator, James F. Bena is a statistician, Gregory Horvath was a nurse manager in the medical intensive care unit, Sue Wilson is a nurse manager in the surgical intensive care unit, Rosslyn Van Den Bossche is assistant nursing director of the Heart and Vascular Institute, Nemy Vargas is a nurse manager in the medical intensive care unit, Victoria Rhoades is a nurse manager in the neuroscience intensive care unit, Katrina M. Hartig was a nurse manager in the cardiovascular intensive care unit, Heather Lachiewicz is a nurse manager in the cardiovascular intensive care unit, and Terri Murray is a nurse manager in the cardiovascular stepdown/telemetry unit at Cleveland Clinic. albertn@ccf.org.
authors.forename: Nancy M
authors.initials: NM
authors.lastname: Albert
authors.affiliation: Nancy M. Albert is the associate chief nursing officer, Office of Research and Innovation-Nursing Institute and a clinical nurse specialist, Kaufman Center for Heart Failure-Heart and Vascular Institute at Cleveland Clinic in Cleveland, Ohio. She is also an adjunct professor at Aalborg University in Aalborg, Denmark, and an adjunct associate professor at Case Western Reserve University, Francis Payne Bolton School of Nursing in Cleveland, Ohio. Ellen Slifcak is a research nurse, Joel D. Roach is a research coordinator, James F. Bena is a statistician, Gregory Horvath was a nurse manager in the medical intensive care unit, Sue Wilson is a nurse manager in the surgical intensive care unit, Rosslyn Van Den Bossche is assistant nursing director of the Heart and Vascular Institute, Nemy Vargas is a nurse manager in the medical intensive care unit, Victoria Rhoades is a nurse manager in the neuroscience intensive care unit, Katrina M. Hartig was a nurse manager in the cardiovascular intensive care unit, Heather Lachiewicz is a nurse manager in the cardiovascular intensive care unit, and Terri Murray is a nurse manager in the cardiovascular stepdown/telemetry unit at Cleveland Clinic.
authors.forename: Ellen
authors.initials: E
authors.lastname: Slifcak
authors.affiliation: Nancy M. Albert is the associate chief nursing officer, Office of Research and Innovation-Nursing Institute and a clinical nurse specialist, Kaufman Center for Heart Failure-Heart and Vascular Institute at Cleveland Clinic in Cleveland, Ohio. She is also an adjunct professor at Aalborg University in Aalborg, Denmark, and an adjunct associate professor at Case Western Reserve University, Francis Payne Bolton School of Nursing in Cleveland, Ohio. Ellen Slifcak is a research nurse, Joel D. Roach is a research coordinator, James F. Bena is a statistician, Gregory Horvath was a nurse manager in the medical intensive care unit, Sue Wilson is a nurse manager in the surgical intensive care unit, Rosslyn Van Den Bossche is assistant nursing director of the Heart and Vascular Institute, Nemy Vargas is a nurse manager in the medical intensive care unit, Victoria Rhoades is a nurse manager in the neuroscience intensive care unit, Katrina M. Hartig was a nurse manager in the cardiovascular intensive care unit, Heather Lachiewicz is a nurse manager in the cardiovascular intensive care unit, and Terri Murray is a nurse manager in the cardiovascular stepdown/telemetry unit at Cleveland Clinic.
authors.forename: Joel D
authors.initials: JD
authors.lastname: Roach
authors.affiliation: Nancy M. Albert is the associate chief nursing officer, Office of Research and Innovation-Nursing Institute and a clinical nurse specialist, Kaufman Center for Heart Failure-Heart and Vascular Institute at Cleveland Clinic in Cleveland, Ohio. She is also an adjunct professor at Aalborg University in Aalborg, Denmark, and an adjunct associate professor at Case Western Reserve University, Francis Payne Bolton School of Nursing in Cleveland, Ohio. Ellen Slifcak is a research nurse, Joel D. Roach is a research coordinator, James F. Bena is a statistician, Gregory Horvath was a nurse manager in the medical intensive care unit, Sue Wilson is a nurse manager in the surgical intensive care unit, Rosslyn Van Den Bossche is assistant nursing director of the Heart and Vascular Institute, Nemy Vargas is a nurse manager in the medical intensive care unit, Victoria Rhoades is a nurse manager in the neuroscience intensive care unit, Katrina M. Hartig was a nurse manager in the cardiovascular intensive care unit, Heather Lachiewicz is a nurse manager in the cardiovascular intensive care unit, and Terri Murray is a nurse manager in the cardiovascular stepdown/telemetry unit at Cleveland Clinic.
authors.forename: James F
authors.initials: JF
authors.lastname: Bena
authors.affiliation: Nancy M. Albert is the associate chief nursing officer, Office of Research and Innovation-Nursing Institute and a clinical nurse specialist, Kaufman Center for Heart Failure-Heart and Vascular Institute at Cleveland Clinic in Cleveland, Ohio. She is also an adjunct professor at Aalborg University in Aalborg, Denmark, and an adjunct associate professor at Case Western Reserve University, Francis Payne Bolton School of Nursing in Cleveland, Ohio. Ellen Slifcak is a research nurse, Joel D. Roach is a research coordinator, James F. Bena is a statistician, Gregory Horvath was a nurse manager in the medical intensive care unit, Sue Wilson is a nurse manager in the surgical intensive care unit, Rosslyn Van Den Bossche is assistant nursing director of the Heart and Vascular Institute, Nemy Vargas is a nurse manager in the medical intensive care unit, Victoria Rhoades is a nurse manager in the neuroscience intensive care unit, Katrina M. Hartig was a nurse manager in the cardiovascular intensive care unit, Heather Lachiewicz is a nurse manager in the cardiovascular intensive care unit, and Terri Murray is a nurse manager in the cardiovascular stepdown/telemetry unit at Cleveland Clinic.
authors.forename: Gregory
authors.initials: G
authors.lastname: Horvath
authors.affiliation: Nancy M. Albert is the associate chief nursing officer, Office of Research and Innovation-Nursing Institute and a clinical nurse specialist, Kaufman Center for Heart Failure-Heart and Vascular Institute at Cleveland Clinic in Cleveland, Ohio. She is also an adjunct professor at Aalborg University in Aalborg, Denmark, and an adjunct associate professor at Case Western Reserve University, Francis Payne Bolton School of Nursing in Cleveland, Ohio. Ellen Slifcak is a research nurse, Joel D. Roach is a research coordinator, James F. Bena is a statistician, Gregory Horvath was a nurse manager in the medical intensive care unit, Sue Wilson is a nurse manager in the surgical intensive care unit, Rosslyn Van Den Bossche is assistant nursing director of the Heart and Vascular Institute, Nemy Vargas is a nurse manager in the medical intensive care unit, Victoria Rhoades is a nurse manager in the neuroscience intensive care unit, Katrina M. Hartig was a nurse manager in the cardiovascular intensive care unit, Heather Lachiewicz is a nurse manager in the cardiovascular intensive care unit, and Terri Murray is a nurse manager in the cardiovascular stepdown/telemetry unit at Cleveland Clinic.
authors.forename: Sue
authors.initials: S
authors.lastname: Wilson
authors.affiliation: Nancy M. Albert is the associate chief nursing officer, Office of Research and Innovation-Nursing Institute and a clinical nurse specialist, Kaufman Center for Heart Failure-Heart and Vascular Institute at Cleveland Clinic in Cleveland, Ohio. She is also an adjunct professor at Aalborg University in Aalborg, Denmark, and an adjunct associate professor at Case Western Reserve University, Francis Payne Bolton School of Nursing in Cleveland, Ohio. Ellen Slifcak is a research nurse, Joel D. Roach is a research coordinator, James F. Bena is a statistician, Gregory Horvath was a nurse manager in the medical intensive care unit, Sue Wilson is a nurse manager in the surgical intensive care unit, Rosslyn Van Den Bossche is assistant nursing director of the Heart and Vascular Institute, Nemy Vargas is a nurse manager in the medical intensive care unit, Victoria Rhoades is a nurse manager in the neuroscience intensive care unit, Katrina M. Hartig was a nurse manager in the cardiovascular intensive care unit, Heather Lachiewicz is a nurse manager in the cardiovascular intensive care unit, and Terri Murray is a nurse manager in the cardiovascular stepdown/telemetry unit at Cleveland Clinic.
authors.forename: Rosslyn
authors.initials: R
authors.lastname: Van Den Bossche
authors.affiliation: Nancy M. Albert is the associate chief nursing officer, Office of Research and Innovation-Nursing Institute and a clinical nurse specialist, Kaufman Center for Heart Failure-Heart and Vascular Institute at Cleveland Clinic in Cleveland, Ohio. She is also an adjunct professor at Aalborg University in Aalborg, Denmark, and an adjunct associate professor at Case Western Reserve University, Francis Payne Bolton School of Nursing in Cleveland, Ohio. Ellen Slifcak is a research nurse, Joel D. Roach is a research coordinator, James F. Bena is a statistician, Gregory Horvath was a nurse manager in the medical intensive care unit, Sue Wilson is a nurse manager in the surgical intensive care unit, Rosslyn Van Den Bossche is assistant nursing director of the Heart and Vascular Institute, Nemy Vargas is a nurse manager in the medical intensive care unit, Victoria Rhoades is a nurse manager in the neuroscience intensive care unit, Katrina M. Hartig was a nurse manager in the cardiovascular intensive care unit, Heather Lachiewicz is a nurse manager in the cardiovascular intensive care unit, and Terri Murray is a nurse manager in the cardiovascular stepdown/telemetry unit at Cleveland Clinic.
authors.forename: Nemy
authors.initials: N
authors.lastname: Vargas
authors.affiliation: Nancy M. Albert is the associate chief nursing officer, Office of Research and Innovation-Nursing Institute and a clinical nurse specialist, Kaufman Center for Heart Failure-Heart and Vascular Institute at Cleveland Clinic in Cleveland, Ohio. She is also an adjunct professor at Aalborg University in Aalborg, Denmark, and an adjunct associate professor at Case Western Reserve University, Francis Payne Bolton School of Nursing in Cleveland, Ohio. Ellen Slifcak is a research nurse, Joel D. Roach is a research coordinator, James F. Bena is a statistician, Gregory Horvath was a nurse manager in the medical intensive care unit, Sue Wilson is a nurse manager in the surgical intensive care unit, Rosslyn Van Den Bossche is assistant nursing director of the Heart and Vascular Institute, Nemy Vargas is a nurse manager in the medical intensive care unit, Victoria Rhoades is a nurse manager in the neuroscience intensive care unit, Katrina M. Hartig was a nurse manager in the cardiovascular intensive care unit, Heather Lachiewicz is a nurse manager in the cardiovascular intensive care unit, and Terri Murray is a nurse manager in the cardiovascular stepdown/telemetry unit at Cleveland Clinic.
authors.forename: Victoria
authors.initials: V
authors.lastname: Rhoades
authors.affiliation: Nancy M. Albert is the associate chief nursing officer, Office of Research and Innovation-Nursing Institute and a clinical nurse specialist, Kaufman Center for Heart Failure-Heart and Vascular Institute at Cleveland Clinic in Cleveland, Ohio. She is also an adjunct professor at Aalborg University in Aalborg, Denmark, and an adjunct associate professor at Case Western Reserve University, Francis Payne Bolton School of Nursing in Cleveland, Ohio. Ellen Slifcak is a research nurse, Joel D. Roach is a research coordinator, James F. Bena is a statistician, Gregory Horvath was a nurse manager in the medical intensive care unit, Sue Wilson is a nurse manager in the surgical intensive care unit, Rosslyn Van Den Bossche is assistant nursing director of the Heart and Vascular Institute, Nemy Vargas is a nurse manager in the medical intensive care unit, Victoria Rhoades is a nurse manager in the neuroscience intensive care unit, Katrina M. Hartig was a nurse manager in the cardiovascular intensive care unit, Heather Lachiewicz is a nurse manager in the cardiovascular intensive care unit, and Terri Murray is a nurse manager in the cardiovascular stepdown/telemetry unit at Cleveland Clinic.
authors.forename: Katrina M
authors.initials: KM
authors.lastname: Hartig
authors.affiliation: Nancy M. Albert is the associate chief nursing officer, Office of Research and Innovation-Nursing Institute and a clinical nurse specialist, Kaufman Center for Heart Failure-Heart and Vascular Institute at Cleveland Clinic in Cleveland, Ohio. She is also an adjunct professor at Aalborg University in Aalborg, Denmark, and an adjunct associate professor at Case Western Reserve University, Francis Payne Bolton School of Nursing in Cleveland, Ohio. Ellen Slifcak is a research nurse, Joel D. Roach is a research coordinator, James F. Bena is a statistician, Gregory Horvath was a nurse manager in the medical intensive care unit, Sue Wilson is a nurse manager in the surgical intensive care unit, Rosslyn Van Den Bossche is assistant nursing director of the Heart and Vascular Institute, Nemy Vargas is a nurse manager in the medical intensive care unit, Victoria Rhoades is a nurse manager in the neuroscience intensive care unit, Katrina M. Hartig was a nurse manager in the cardiovascular intensive care unit, Heather Lachiewicz is a nurse manager in the cardiovascular intensive care unit, and Terri Murray is a nurse manager in the cardiovascular stepdown/telemetry unit at Cleveland Clinic.
authors.forename: Heather
authors.initials: H
authors.lastname: Lachiewicz
authors.affiliation: Nancy M. Albert is the associate chief nursing officer, Office of Research and Innovation-Nursing Institute and a clinical nurse specialist, Kaufman Center for Heart Failure-Heart and Vascular Institute at Cleveland Clinic in Cleveland, Ohio. She is also an adjunct professor at Aalborg University in Aalborg, Denmark, and an adjunct associate professor at Case Western Reserve University, Francis Payne Bolton School of Nursing in Cleveland, Ohio. Ellen Slifcak is a research nurse, Joel D. Roach is a research coordinator, James F. Bena is a statistician, Gregory Horvath was a nurse manager in the medical intensive care unit, Sue Wilson is a nurse manager in the surgical intensive care unit, Rosslyn Van Den Bossche is assistant nursing director of the Heart and Vascular Institute, Nemy Vargas is a nurse manager in the medical intensive care unit, Victoria Rhoades is a nurse manager in the neuroscience intensive care unit, Katrina M. Hartig was a nurse manager in the cardiovascular intensive care unit, Heather Lachiewicz is a nurse manager in the cardiovascular intensive care unit, and Terri Murray is a nurse manager in the cardiovascular stepdown/telemetry unit at Cleveland Clinic.
authors.forename: Terri
authors.initials: T
authors.lastname: Murray
mesh_terms: D016000:Cluster Analysis; D003428:Cross Infection / Q000453:epidemiology*; D004209:Disposable Equipment / Q000706:statistics & numerical data*; D004562:Electrocardiography / Q000295:instrumentation*; D005260:Female; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009820:Ohio / Q000453:epidemiology; D053717:Pneumonia, Ventilator-Associated / Q000453:epidemiology; D013530:Surgical Wound Infection / Q000453:epidemiology