A continuous quality improvement project to decrease hemodialysis catheter infections in pediatric patients: use of a closed luer-lock access cap.

Catheter infections are a significant problem in pediatric hemodialysis. To reduce infection rates, the use of closed luer-lock access connectors, which create a mechanically and microbiogically closed system while allowing unobstructed blood flow, was implemented Infection rates fell from 7.8 infections per 1000 patient days to 3.65 infections per 1000 patient days after the switch to the closed connector (t = 0.04). The adoption of a closed connector system appeared to produce a significant reduction in bloodstream infections.