A COMPARISON OF INTRAVASCULAR PRESSURE MONITORING-SYSTEM CONTAMINATION AND PATIENT BACTEREMIA WITH USE OF 48-HOUR AND 72-HOUR SYSTEM CHANGEINTERVALS

OBJECTIVE: To determine the incidence of culture positivity in intrava scular monitoring systems by comparing 48- versus 72-hour intervals fo r flush solution, stopcocks, and catheters on removal. DESIGN: Prospec tive, quasi-experimental, random assignment. SETTING: Intensive care u nits of a midwestern university medical center and a community hospita l. PATIENTS: Seventy-six critically ill adult patients, ranging in age from 24 to 96 years (X = 61.6), requiring arterial or pulmonary arter y catheters. OUTCOME MEASURE: Culture positivity of flush solution, st opcocks, or catheter tips. INTERVENTION: Data collection was initiated at designated change intervals of 48- or 72-hours; cultures were take n of flush solution and stopcocks: catheter tip cultures were obtained on catheter removal. RESULTS: Chi-square analyses indicated that incr easing the change interval to 72 hours resulted in no significant diff erence in culture positivity of catheter tips. However, the difference between the 48- and 72-hour groups in culture-positivity rates of sto pcocks from arterial catheters was significant (1, N = 82) = 6.86, p l ess than 0.01. CONCLUSIONS: Our results showed that increasing the cha nge interval to 72 hours did not increase the risk of catheter-associa ted infection or catheter-associated bacteremia. Chi-square analysis d id not show an association between culture-positive stopcocks, the inc idence of culture-positive catheter tips, entries into the system, or catheter-related bacteremia and a change interval that was increased t o 72 hours. Thus, increasing the change interval to 72 hours does not increase the risk of infection.