Optimizing disinfection of needleless connector hubs is a key strategy for preventing central line-associated bloodstream infections, but the optimal method of disinfection is unclear. Moreover, staff compliance with instructions for disinfectant use is one of the main barriers to achieving adequate disinfection. In a mixed-methods study, researchers compared the efficacy of three products for experimental disinfection of needleless connectors and conducted a qualitative nursing assessment of each product.

Needleless connectors were inoculated with Staphylococcus epidermidis, Pseudomonas aeruginosa, and Staphylococcus aureus, followed by dry times of 30 minutes to two hours. The needleless connectors were then disinfected with a 70% isopropyl alcohol (IPA) wipe, a 70% IPA cap, or a 3.15% chlorhexidine gluconate with 70% IPA (CHG/IPA) wipe. The times for scrub and dry were, respectively, 15 seconds and 15 seconds for the IPA wipes, 10 seconds and five seconds for the IPA caps, and five seconds and five seconds for the CHG/IPA wipes. A total of 35 nurses from five ICUs were asked to provide feedback on the three products and about their perceptions of their colleagues' scrub practices.

All three products significantly reduced bacterial growth when compared with scrubbing with sterile water. The IPA and CHG/IPA wipes, however, were superior to the IPA caps.

The most common reason why a product was preferred by nurses was the time required for scrubbing and drying. Many preferred the bigger, wetter CHG/IPA wipes. Although 90% of nurses said they complied with recommended scrubbing and drying times, they estimated that only 10% of their colleagues did so.

The authors caution that the laboratory evaluations of product efficacy in this study may have limited generalizability to clinical settings. Also, the study was performed in a single center and only among ICU nurses.