Memo

To: Martha Seahorn, Chief Nursing Officer at Gadsden Regional Medical Center

From: Gary Parker, 7F Department Director at Gadsden Regional Medical Center

Date: November 11, 2017

Re: Biopatch data shows ineffective at reducing central line-associated blood stream infections

Problem: Data shows an increase in central line-associated blood stream infections. Several processes have
changed since the increase such as the placement of a different type of peripheral inserted central catheter
and the introduction of Biopatch to central line dressings instead of teagderm dressings with chlorhexidine
gluconate.

Data: Research was studied on the effectiveness of Biopatch in regard to central line blood stream infections
and a change back to tegaderm dressings with chlorhexidine gluconate is necessary to reduce incidences of
central line-associated blood stream infections.

Washington School of Medicine performed a randomized controlled trial consisting of 1088 patients and
evaluated standard of care in regard to central venous lines and standard of care with the addition of
Biopatch. The data states that the use of Biopatch in addition to the standard of care shows a reduction of
blood stream infections by 0.02 per 1000 catheter days. The results of this trial didn’t yield the difference that
was estimated from the preliminary data.

Another randomized controlled trial performed by B.L. Roberts and D. Cheongsam actually showed an
increase in positive CVC tip cultures by 5.5% and exit site swabs by 4.7% with the addition of Biopatch. Only
thirty—two patients were involved in this study and a much larger sample size could be utilized to help draw
more accurate conclusions.

Ritzmann, Parsons, Majani, Srinivasan and Wilne performed another randomized controlled trial that
collected data for 3 six-month periods (2 six-month periods before the introduction of Biopatch, and 1 six-
month period after the introduction of Biopatch). After introduction of Biopatch, more central venous lines
were removed due to infection and more positive blood cultures were collected. Biopatch did help reduce the
exit-site infection rate but more systemic infections were noted.

Recommendation: In order to decrease the amount of central line-associated blood stream infections, the
data states that the infection rate is lower utilizing standard of care in regard to central venous lines without
the addition of Biopatch.

As the 7th Floor Department Director and Co-chair on the committee to reduce central line-associated blood
stream infections, I have significant knowledge in regard to the current infection rate and current practices of
each unit and how that is provided to our patients. Our patients deserve care that is proven by current
evidence and as stated above, the evidence doesn’t support the use of Biopatch in order to reduce central
line-associated blood stream infections.