title: Sterile v aseptic non-touch technique for needle-less connector care on central venous access devices in a bone marrow transplant population: A comparative study.
abstract: OBJECTIVE
  The aim of this study was to determine whether a variation in practice from an aseptic non-touch technique (ANTT) to a sterile technique when changing needleless connectors on central venous access devices (CVAD) was associated with any change in catheter related bloodstream infection (CRBSI) rates in the bone marrow transplant (BMT) population.
  
  
  METHODS
  A two group comparative study without concurrent controls using a retrospective cohort was conducted in a large metropolitan hospital in Brisbane, Australia.
  
  
  METHODS
  haematological malignancy, Hickman catheter inserted, age ≥18. A tool was developed to extract historical data from medical records and pathology results.
  
  
  METHODS
  CRBSI.
  
  
  RESULTS
  laboratory confirmed bloodstream infection, mucosal barrier injury laboratory confirmed bloodstream infection and skin contaminants.
  
  
  RESULTS
  One hundred and fifty patients were assessed, 73/150 (49%) in the ANTT group.
  
  
  METHODS
  males 95/150 (63%), with 71/150 (47%) receiving an autologous BMT. No difference in CRBSI rates between groups was observed (ANTT n = 3 (4%) vs Sterile n = 1 (2.7%), p = 0.357 Fishers Exact Test). Infection by skin contaminants were identified in a similar number of cases across both groups (ANTT n = 9 (12.3%) vs Sterile n = 6 (7.8%)).
  
  
  CONCLUSIONS
  No causal effect can be deduced from this small study; nevertheless results imply that an ANTT was not associated with increased CRBSI. Poor hand hygiene and ANTT were perceived across both groups. Quality and consistent ANTT is a safe method for managing intravascular devices, however education and awareness of pathogen transfer from healthcare worker and patient to their device is required.
authors.affiliation: Alliance for Vascular Access Teaching and Research (AVATAR Group), NHMRC Centre of Research Excellence in Nursing, Centre for Health Practice Innovation, Griffith University, Brisbane, Australia; Cancer Care Services, Royal Brisbane & Women's Hospital, Brisbane, Australia. Electronic address: julie.flynn@griffith.edu.au.
authors.forename: Julie M
authors.initials: JM
authors.lastname: Flynn
authors.affiliation: Alliance for Vascular Access Teaching and Research (AVATAR Group), NHMRC Centre of Research Excellence in Nursing, Centre for Health Practice Innovation, Griffith University, Brisbane, Australia.
authors.forename: Samantha J
authors.initials: SJ
authors.lastname: Keogh
authors.affiliation: Alliance for Vascular Access Teaching and Research (AVATAR Group), NHMRC Centre of Research Excellence in Nursing, Centre for Health Practice Innovation, Griffith University, Brisbane, Australia; Cancer Care Services, Royal Brisbane & Women's Hospital, Brisbane, Australia.
authors.forename: Nicole C
authors.initials: NC
authors.lastname: Gavin
mesh_terms: D000328:Adult; D000891:Anti-Infective Agents, Local / Q000494:pharmacology; D017848:Blood-Borne Pathogens / Q000187:drug effects*; D016026:Bone Marrow Transplantation / Q000009:adverse effects / Q000379:methods*; D055499:Catheter-Related Infections / Q000517:prevention & control*; D062905:Central Venous Catheters / Q000009:adverse effects*; D016009:Chi-Square Distribution; D015331:Cohort Studies; D003428:Cross Infection / Q000517:prevention & control; D004203:Disinfection / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006784:Hospitals, Teaching; D006801:Humans; D008297:Male; D008875:Middle Aged; D009339:Needles; D011793:Queensland; D012189:Retrospective Studies; D018570:Risk Assessment; D013242:Sterilization / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D000891:Anti-Infective Agents, Local
keywords: Aseptic non-touch technique; Bloodstream infection; Bone marrow transplant; Catheter related bloodstream infection; Central venous access device; Needleless connector