The public health burden associated with catheter‐related bloodstream infection (CRBSI*) is substantial. A publication reviewing the qualitative and quantitative evidence supporting the use of Mastisol® Liquid Adhesive for the reduction of CRBSI can be downloaded here. In this blog, we’ll review the important findings detailed in this publication.
CRBSI vs CLABSI These two terms are often used interchangeably, yet there are important differences:
- Catheter‐related bloodstream infection (CRBSI): Laboratory‐confirmed bloodstream infection (BSI); requires laboratory evidence that the catheter is the source. Not typically used for surveillance purposes.
- Central line‐associated bloodstream infection (CLABSI): Laboratory‐confirmed BSI in a patient in whom a central line is present within 48 hours before the development of the BSI, and not related to an infection at another site.
Hospital‐acquired infections result in increased morbidity and mortality, increased length of hospital stay, and increased costs. Multiple organizations have published evidence‐based guidelines for the prevention of CRBSI, and reports confirm that hospitals have been able to reduce incidence of CLABSI by up to 70% by adhering to evidence‐based interventions.
Mastisol® Liquid Adhesive is a medical adhesive used to secure dressings, tapes and certain medical devices in order to ensure secure placement over an extended period of time. Mastisol can:
1. Help your staff adhere to evidence based guidelines for the prevention of CRBSI
2. Decrease the risk of dressing disruption and CRBSI
3. Improve patient satisfaction
4. Decrease costs
1. Mastisol® Liquid Adhesive and Adherence to Evidence‐Based Guidelines
In order to prevent CRBSIs, the standard of care for catheters and dressings has shifted from routine scheduled replacement to replacement only when clinically indicated up to every 7 days. The Infusion Therapy Standards of Practice recommends replacement of dressings should they become damp, loose, or visibly soiled. Importantly, the recommendations also state to avoid the use of tape to reinforce the dressing, because rolls of non‐sterile tape can be contaminated with bacteria.
Mastisol® Liquid Adhesive can help staff adhere to best practice recommendations by preventing the loosening of dressings for up to 7 days. This may prevent catheter insertion‐site exposure and catheter dislodgement.
Mastisol Liquid Adhesive is CHG‐compatible
Use of Mastisol will not impact the antimicrobial action of chlorahexadine gluconate (CHG)
2. Mastisol® Liquid Adhesive Can Decrease the Risk of Dressing Disruption and CRBSI Dressing disruption or nonadherence is common – prevalence reports indicate it occurs in up to 57% of dressings.
This is important, because evidence suggests that dressing disruption is a major risk factor for CRBSIs. In a 2012 study, the risk of major catheter‐related infection and catheter‐related bloodstream infection increased by more than 3‐fold after the second dressing disruption and 12‐fold if the final dressing was disrupted.
One recent study found that 4 commercially available central venous catheter dressings had surprisingly limited durability. A total of 75% of the dressings lasted less than 48 hours, and only 3% of dressings lasted a full 7 days. Evidence that Mastisol® Liquid Adhesive reduces dressing disruption and may reduce the risk of skin or catheter colonization or CRBSI related to dressing disruption is provided in 3 case studies:
In 2014, Florida Hospital conducted a before/after quality improvement study, which showed that the use of Mastisol Liquid Adhesive was associated with fewer disrupted dressings compared to standard of care.
In 2016, a quality improvement initiative was conducted on a Hematology/Oncology & Bone Marrow Transplant unit to reduce central‐line dressing disruptions. Mastisol incorporation into the bundle of care resulted in a 76% reduction in CLABSI rates. Staff agreed that Mastisol was easy to incorporate into the care bundle.
In 2017, a Methodist facility implemented a dressing bundle with gum mastic and adhesive remover. After assessing 8,000 peripheral IV insertions, dressing integrity was improved and no dressing‐related skin injuries were reported (based on consultation with wound nurses).
3. Mastisol® Liquid Adhesive Can Improve Patient Satisfaction Procedure‐related pain leads to patient dissatisfaction, often with negative emotional and psychologic implications. As hospitals have shifted to the pay‐for‐performance model, interventions for improving patient satisfaction have increased in importance.
Several studies have shown that Mastisol enhances the adherence of dressings and tapes and reduces the risk of catheter dislodgement. This can help avoid unnecessary procedures associated with catheter reinsertion, which can have a direct effect on patient perceptions of care.
Safety: Mastisol® Liquid Adhesive Found to be Safe and effective compared to tincture of benzoin
Mastisol has a low incidence of allergic reactions, increases dressing/device integrity,
and is compatible with CHG.
4. Mastisol® Liquid Adhesive Can Reduce Costs
Reducing dressing disruption can reduce the risk of hospital‐acquired infection, which has a direct effect on your facilities’ bottom line – both in direct costs and the impact on the value‐based purchasing model and total performance score.
Cost avoidance resulting from inclusion of Mastisol® Liquid Adhesive can include:
• Minimizing cost associated with premature dressing changes (estimated from $5.00 to $9.50 per dressing)
• Reduction in CLABSI excess costs (ranging from $29,156 to $46,685)
• Time savings due to fewer dressing disruptions
• Improved patient satisfaction by avoiding unnecessary procedures
For more information about Mastisol®, please contact your sales consultant or Eloquest Healthcare®, Inc., call 1‐877‐433‐7626 or visit www.eloquesthealthcare.com.
Minimizing infection risk is an essential part of optimizing “The Triple Aim” of the Affordable Care Act. Eloquest Healthcare is committed to providing solutions that can help you reduce the risk of conditions like a central line‐associated bloodstream infection (CLABSI) and post‐operative wound contamination.
Reference:
1. Mastisol® Liquid Adhesive Evidence Based White Paper. Eloquest Healthcare, Inc. May 2018. Available at:
https://eloquesthealthcare.com/mastisol/resources/.
