{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T08:21:17Z","timestamp":1774340477861,"version":"3.50.1"},"reference-count":17,"publisher":"Cambridge University Press (CUP)","issue":"8","license":[{"start":{"date-parts":[[2024,2,23]],"date-time":"2024-02-23T00:00:00Z","timestamp":1708646400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S0899823X24000229_as1\"><jats:title>Objective:<\/jats:title><jats:p>Evidence-based central-line\u2013associated bloodstream infection (CLABSI) prevention guidelines recommend the use of an antiseptic scrub to disinfect needleless connectors before device access. Guideline noncompliance may render disinfection ineffective. The goal of this study was to observe needleless-connector disinfection practices and to identify perceived facilitators and barriers to best practices of needleless-connector access.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X24000229_as2\"><jats:title>Methods:<\/jats:title><jats:p>A human factors mixed-methods study involving nursing focus groups of perceived barriers and facilitators and clinical observations of compliance with instructions and protocols for use of 3.15% chlorhexidine gluconate\/70% isopropyl alcohol (CHG\/IPA) and 70% isopropyl alcohol (IPA) antisepsis products for central venous access device (CVAD) needleless-connector disinfection was conducted in intensive care units (ICUs) at 2 academic medical centers.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X24000229_as3\"><jats:title>Results:<\/jats:title><jats:p>Access to the antiseptic product and lesser workload were identified as best-practice facilitators. Barriers were the time required per needleless-connector access and knowledge deficits. Of the 48 observed access events, 77% resulted in needleless-connector disinfection. The observed mean needleless-connector scrubbing times when using IPA were substantially below the recommended time. Drying time after product use was negligible.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X24000229_as4\"><jats:title>Conclusions:<\/jats:title><jats:p>Lack of access to the disinfection product, emergency situations, and high workload were barriers to needleless-connector disinfection. Observed scrubbing and drying times were shorter than recommended, especially for IPA wipes. These needleless-connector disinfection deficits may increase the risk of CLABSI. Ongoing education and periodic competency evaluation of needleless-connector disinfection, improvement of supply management, and staffing workload are required to imbed and sustain best practices. Further study involving a larger sample size in diverse patient populations is warranted.<\/jats:p><\/jats:sec>","DOI":"10.1017\/ice.2024.22","type":"journal-article","created":{"date-parts":[[2024,2,23]],"date-time":"2024-02-23T08:22:42Z","timestamp":1708676562000},"page":"959-964","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":2,"title":["Disinfection of central venous access device needleless connectors: A human factors analysis"],"prefix":"10.1017","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4263-4602","authenticated-orcid":false,"given":"Frank A.","family":"Drews","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0355-9200","authenticated-orcid":false,"given":"Richard A.","family":"Martinello","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joan N.","family":"Hebden","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-0623-7424","authenticated-orcid":false,"given":"Keith H.","family":"St. John","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David A.","family":"Pegues","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2024,2,23]]},"reference":[{"key":"S0899823X24000229_ref15","doi-asserted-by":"publisher","DOI":"10.1191\/1478088706qp063oa"},{"key":"S0899823X24000229_ref6","doi-asserted-by":"publisher","DOI":"10.2309\/java.12-3-9"},{"key":"S0899823X24000229_ref12","doi-asserted-by":"publisher","DOI":"10.1111\/2041-210X.12584"},{"key":"S0899823X24000229_ref2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cir257"},{"key":"S0899823X24000229_ref3","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2022.87"},{"key":"S0899823X24000229_ref17","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.d8262"},{"key":"S0899823X24000229_ref16","unstructured":"16. Curos disinfecting cap for needless connectors. 3M website. https:\/\/multimedia.3m.com\/mws\/media\/1268904O\/how-to-use-curos-disinfecting-cap-for-needleless-connectors.pdf. Accessed July 7, 2023."},{"key":"S0899823X24000229_ref7","doi-asserted-by":"publisher","DOI":"10.1016\/j.java.2012.07.008"},{"key":"S0899823X24000229_ref13","volume-title":"Mosby\u2019s Pocket Guide to Nursing Skills and Procedures, 9th Edition","author":"Griffin Perry","year":"2019"},{"key":"S0899823X24000229_ref9","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2018.05.007"},{"key":"S0899823X24000229_ref11","doi-asserted-by":"publisher","DOI":"10.1016\/S0195-6701(13)60012-2"},{"key":"S0899823X24000229_ref1","doi-asserted-by":"publisher","DOI":"10.1155\/2015\/796762"},{"key":"S0899823X24000229_ref14","volume-title":"R: A Language and Environment for Statistical Computing","year":"2021"},{"key":"S0899823X24000229_ref8","doi-asserted-by":"publisher","DOI":"10.1086\/666337"},{"key":"S0899823X24000229_ref10","doi-asserted-by":"publisher","DOI":"10.12968\/bjon.2018.27.2.S18"},{"key":"S0899823X24000229_ref5","doi-asserted-by":"publisher","DOI":"10.1097\/01.NUMA.0000390461.26871.25"},{"key":"S0899823X24000229_ref4","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2015.219"}],"container-title":["Infection Control &amp; Hospital Epidemiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0899823X24000229","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,19]],"date-time":"2025-03-19T08:38:59Z","timestamp":1742373539000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0899823X24000229\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2,23]]},"references-count":17,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2024,8]]}},"alternative-id":["S0899823X24000229"],"URL":"https:\/\/doi.org\/10.1017\/ice.2024.22","relation":{},"ISSN":["0899-823X","1559-6834"],"issn-type":[{"value":"0899-823X","type":"print"},{"value":"1559-6834","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,2,23]]},"assertion":[{"value":"\u00a9 The Author(s), 2024. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}]}}