Safe connections webinar: open vs closed IV access

How can we define safe connections?

Connections are critical junctures and/or points of access along intravenous (IV) lines. Microorganisms may colonise these connections, potentially leading to catheter-related bloodstream infections (CRBSIs).1,2 For patients, CRBSIs are a significant cause of morbidity and mortality.3 As for healthcare facilities, these infectious complications lead to unecessary costs, but solutions exist to help prevent them.3 

Nancy L. Trick, Registered Nurse and Adjunct Instructor at Perdue Global University in West Lafayette, IN, USA, presented at the “Safe connections in vascular access management (VAM)” webinar. 

According to the World Health Organisation, patient safety is defined as “the absence of preventable harm to a patient and reduction of risk of unnecessary harm associated with health care to an acceptable minimum.”4 

Safe connections may help reduce the risk of needlestick injuries for healthcare professionals (HCPs) and the occurrence of CRBSIs for patients.5 

More on this topic: 12 practice guidelines for needleless connector best practice

Comparing connections: open vs closed IV catheter access

Open IV access systems

“Stopcocks are an open system and require some type of closure to reduce the entry of microorganisms into the lumen [such as] a sterile dead-end cap.”1 If left uncapped, they present a significant risk of contamination, resulting in CRBSIs.1 Needlestick injuries may lead to bloodborne pathogens transmited to injured HCPs.6 

Closed IV access systems

Needleless connectors in IV catheter systems offer the possibility of eliminating the use of needles to help reduce needlestick injuries in healthcare professionals.7 They may also contribute to patient safety by reducing the risk of microbial contamination.5 

More on this topic: Peripheral venous catheters: Cost impact of PVC care bundles

Safe connections webinar is still available

After watching this webinar, you should be able to:

  • Describe open versus closed infusion systems in VAM 
  • Briefly discuss the clinical risks of open infusion systems 
  • Discuss clinical practice change  
  • Consider how evidence-based standards of practice recommend using closed IV access/needleless connectors 

Discover how your patients could benefit from needleless connectors. 


  1. Hadaway L. Stopcocks for Infusion Therapy: Evidence and Experience. J Infus Nurs. 2018;41(1):24-34. doi:10.1097/NAN.0000000000000258
  2. Helm RE, Klausner JD, Klemperer JD, Flint LM, Huang E. Accepted but unacceptable: peripheral IV catheter failure. J Infus Nurs. 2015;38(3):189-203. doi:10.1097/NAN.0000000000000100
  3. Hollenbeak CS. The cost of catheter-related bloodstream infections: implications for the value of prevention. J Infus Nurs. 2011;34(5):309-313. doi:10.1097/NAN.0b013e3182285e43
  4. World Health Organisation (WHO). Patient safety. Published September 11, 2023. Accessed November 15, 2023.
  5. Rundjan L, Rohsiswatmo R, Paramita TN, Oeswadi CA. Closed catheter access system implementation in reducing the bloodstream infection rate in low birth weight preterm infants. Front Pediatr. 2015;3:20. doi:10.3389/fped.2015.00020
  6. Tabak YP, Jarvis WR, Sun X, Crosby CT, Johannes RS. Meta-analysis on central line-associated bloodstream infections associated with a needleless intravenous connector with a new engineering design. Am J Infect Control. 2014;42(12):1278-1284. doi:10.1016/j.ajic.2014.08.018
  7. Gorski LA, Hadaway L, Hagle ME, et al. Infusion Therapy Standards of Practice, 8th Edition. J Infus Nurs. 2021;44(1S Suppl 1):S1-S224. doi:10.1097/NAN.0000000000000396


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