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© SICS EBM Group 2004
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Should disinfectable, needle free connectors be used to reduce the incidence of catheter-related bloodstream infections?
Lead author's name & email: Dr Juan C. Yebenes, jcyebenes@csm.scs.es
Three-part Clinical Question: Patients: ICU patients Intervention: Use of disinfectable, needle-free connectors rather than three-way taps Outcome: the rates of catheter-related blood stream infections
Search Terms: Catheter-related bloodstream infections. Disinfectable, needle-free connector The Study: Randomized, semi-blinded controlled trial
Study Patients: All critically ill patients admitted to a 12-bedded intensive care unit who needed a CVC were included. Exclusions were CVCs inserted outside the ICU, those removed before 72 hours of insertion or guide wire insertion.
The Evidence:
EBM questions:
1) Do the methods allow accurate testing of the hypothesis? Yes. Although it is not possible to completely blind this study, it is a well designed randomised study with clear inclusion criteria, a good number of patients and 100% follow up.
2) Do the statistical tests correctly test the results to allow differentiation of statistically significant results? Yes
3) Are conclusions valid in light of the results? Yes
4) Did results get omitted, and why? No
5) Did they suggest areas of further research? No
6) Did they make any recommendations based on the results and were they appropriate? Yes, they recommended adding the addition of disinfectable, needle free connectors to the 1996 CDC recommendations for the insertion of CVC
7) Is the study relevant to my clinical practice? Yes
8) What level of evidence does this study represent? 1+
9) What grade of recommendation can I make on this result alone? B
10) What grade of recommendation can I make when this study is considered along with other available evidence? B
11) Should I change my practice because of these results? Yes
12) Should I audit my current practice because of these results? Yes
Appraised by: Dr Phoebe Brodie, SHO, ICU, Edinburgh Royal Infirmary Email: phoebe.brodie@nhs.net
Citation: EBM Critical Appraisals. Scottish Intensive Care Society EBM Group. Brodie P. 2005: Juan C.Yebenes, et al. Prevention of catheter-related bloodstream infection in critically ill patients using a disinfectable, needle-free connector: A randomized controlled trial. AJIC 2004 32(5): 291-295.
Kill or Update By: MAY 2010 Edited by DS & CC
©SICS EBMG 2005
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