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

•Results suggest ANTT was not associated with increased CRBSI.•Skin contaminants high in both the ANTT and sterile groups.•Increased compliance required for hand hygiene and needle-less connector care.•Needle-less connector and hub decontamination techniques require further research.

PurposeThe 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.MethodsA two group comparative study without concurrent controls using a retrospective cohort was conducted in a large metropolitan hospital in Brisbane, Australia. Inclusion criteria: haematological malignancy, Hickman catheter inserted, age ≥18. A tool was developed to extract historical data from medical records and pathology results. Primary outcome: CRBSI. Secondary outcomes: laboratory confirmed bloodstream infection, mucosal barrier injury laboratory confirmed bloodstream infection and skin contaminants.ResultsOne hundred and fifty patients were assessed, 73/150 (49%) in the ANTT group. Demographics: 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%)).ConclusionsNo 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.