Clinical use of disinfectable needle-free connectors
Background
In 1992, the United States Food and Drug Administration required health care services to adopt needle-free devices to prevent health care workers’ exposure to bloodborne pathogens resulting from needlestick injuries, and several systems of disinfectable needle-free connectors (DNC) were introduced.
Studies: Microbial colonization
Experimental studies showed that DNCs designed with a split septum (SS-DNCs) and mechanical valve systems (MLV-DNC) prevented endoluminal colonization as effectively as needles or conventional caps. A comparison of the microbiologic barrier effect of SS-DNCs, MLV-DNCs, and passive positive-pressure (PPV)-DNCs found that PPV-DNCs were least effective in providing protection under experimental conditions of poor handling practices and high microorganism concentrations.
Prevention of catheter-related bloodstream infections
Some randomized trials show a positive or neutral effect of DNC use on the prevention of catheter-related bloodstream infections (CR-BSIs); however, some investigators have reported outbreaks of CR-BSIs following the introductions of DNCs that could be related to noncompliance with DNC handling recommendations or the use of PPV-DNCs.
Conclusion
Strategies focused in the implication of the nurse staff in CRBSI surveillance increase compliance with DNC handling recommendations and minimize the risk of developing a CR-BSI. DNCs can be used safely if staff complies with recommendations for use.
aIntensive Care Unit, Hospital de Mataró, Barcelona, Spain
bResearch Unit, Hospital de Mataró, Barcelona, Spain
Address correspondence to Juan C. Yébenes, MD, PhD, Hospital de Mataró, Intensive Care Unit, 08304 Mataro, Barcelona, Spain.
Disclosures: Dr. Yébenes received an honorarium for participating in the symposium and writing this article. Dr. Yébenes has received grants to develop an educational program in his hospital from Cardinal Health. Dr. Serra-Prat reports no conflicts of interest.
ABSTRACT