{"id":4790,"date":"2022-11-14T00:00:29","date_gmt":"2022-11-14T00:00:29","guid":{"rendered":"https:\/\/eu.bd.com\/iv-news\/?p=4790"},"modified":"2023-06-01T15:06:17","modified_gmt":"2023-06-01T15:06:17","slug":"12-practice-guidelines-for-needleless-connector-best-practice","status":"publish","type":"post","link":"https:\/\/eu.bd.com\/iv-news\/news-innovation\/12-practice-guidelines-for-needleless-connector-best-practice\/","title":{"rendered":"12 practice guidelines for needleless connector best practice"},"content":{"rendered":"

Used widely in acute care, needleless connectors (NCs) are designed to ensure patient and healthcare worker safety<\/span>1\u20133<\/span><\/sup>.<\/span>\u00a0<\/span><\/p>\n

Focus on risks to patient safety<\/span><\/b>\u00a0<\/span><\/h4>\n
Catheter-related bloodstream infections (CRBSIs)<\/span><\/b>\u00a0<\/span><\/h5>\n

CRBSIs are one of the most frequent, deadly and expensive complications of central venous catheters<\/span>4<\/span><\/sup>. Central venous catheters have a higher risk of catheter-related infections than any other type of medical device<\/span>4<\/span><\/sup>.<\/span>\u00a0<\/span><\/p>\n

More on this topic:<\/span><\/b> The real cost of catheter-related bloodstream infections<\/span><\/a>\u00a0<\/span><\/p>\n

Occlusion<\/span><\/b>\u00a0<\/span><\/h5>\n

Occlusion is one of the five most frequent reasons for peripheral IV catheter (PIVC) failure<\/span>5<\/span><\/sup>. It can be caused by mechanical obstruction<\/span> such as from kinking of the catheter, from catheter migration into a \u201cdead-end\u201d position within the vessel wall or tissue without frank infiltration\/extravasation or from thrombosis of the catheter and\/or surrounding vessel<\/span>5<\/span><\/sup>. Blood reflux can also play a significant role in thrombotic catheter occlusion<\/span>2<\/span><\/sup>.<\/span>\u00a0<\/span><\/p>\n

Incidence of occlusion ranges from 2.5% to 32.7%<\/span>5<\/span><\/sup>.\u00a0<\/span>\u00a0<\/span><\/p>\n

Focus on risks to healthcare worker safety<\/span><\/b>\u00a0<\/span><\/h4>\n
Needlestick injuries<\/span><\/b>\u00a0<\/span><\/h5>\n

Needlestick injuries continue to affect healthcare workers (HCWs). Commonly affected populations are doctors, nurses and medical\/nursing students. Studies have shown that of all occupational exposures, 35% occur among persons in training and 27% among experienced nurses<\/span>6<\/span><\/sup>.\u00a0<\/span>\u00a0<\/span><\/p>\n

Underreporting is a problem with only 9\u201338% of healthcare workers declaring their injuries<\/span>7<\/span><\/sup>. The occurrence of needlestick injuries is most frequent among HCWs having close clinical contact with patients or patient specimens<\/span>7<\/span><\/sup>.<\/span>\u00a0<\/span><\/p>\n

Needleless connectors: an essential device in your vascular access toolkit<\/span><\/b>\u00a0<\/span><\/h4>\n

NCs offer the possibility of connecting administration sets or syringes to vascular access devices (VADs) by eliminating the use of needles<\/span>8<\/span><\/sup>. Along with needlestick injury prevention, these devices are also designed to help prevent IV catheter-related complications<\/span>9<\/span><\/sup>.<\/span>\u00a0<\/span><\/p>\n

The International Nosocomial Infection Control Consortium (INICC) issued<\/span> Care Bundles to Prevent Central and Peripheral Line-Related Bloodstream Infections<\/span><\/i>9<\/span><\/sup>.<\/span>\u00a0<\/span><\/p>\n

To help prevent IV catheter-related complications<\/span><\/b>9<\/span><\/sup>:<\/span><\/b>\u00a0<\/span><\/h5>\n
    \n
  1. Use a luer-lock mechanism to ensure a secure junction when attaching the NC to a VAD or access site<\/span>\u00a0<\/span><\/li>\n
  2. Don\u2019t use three-way stopcocks as IV connection devices<\/span>\u00a0<\/span><\/li>\n
  3. Disinfect NCs before inserting them into each VAD<\/span>\u00a0<\/span><\/li>\n
  4. Use aseptic technique when changing NCs<\/span>\u00a0<\/span><\/li>\n
  5. Only access NCs with a sterile device<\/span>\u00a0<\/span><\/li>\n
  6. Consider using an extension set between the IV line and NC to reduce line manipulations<\/span>\u00a0<\/span><\/li>\n<\/ol>\n
    According to the 8th edition of the <\/span><\/b>Infusion Therapy Standards of Practice<\/span><\/i><\/b>, you should change needleless connectors<\/span><\/b>8<\/span><\/b><\/sup>:<\/span><\/b>\u00a0<\/span><\/h5>\n
      \n
    1. When they are removed for any reason<\/span>\u00a0<\/span><\/li>\n
    2. If blood or debris are found inside them<\/span>\u00a0<\/span><\/li>\n
    3. Before drawing blood samples for culturing from the VAD (which should be avoided when using CVADs because these samples are more likely to produce false positives)\u00a0<\/span><\/li>\n
    4. If contamination occurs<\/span>\u00a0<\/span><\/li>\n
    5. According to your healthcare facility’s policies, procedures and\/or practice guidelines<\/span>\u00a0<\/span><\/li>\n
    6. Per the manufacturers’ directions for use<\/span>\u00a0<\/span><\/li>\n<\/ol>\n

      More on this topic: <\/span><\/b>BD webinar series explores vascular access best practice following release of the 8th edition of the Infusion Therapy Standards of Practice<\/span><\/a>\u00a0<\/span><\/p>\n

      Not all needleless connectors are alike<\/span><\/b>\u00a0<\/span><\/h4>\n

      In 2014, a peer-reviewed meta-analysis by <\/span>Tabak et al. found that NCs should contain the following safety features<\/span>3<\/span><\/sup>:<\/span>\u00a0<\/span><\/p>\n