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 i...

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Bibliographic Details
Published inAmerican journal of infection control Vol. 36; no. 10; pp. S175.e1 - S175.e4
Main Authors Yébenes, Juan C., MD, PhD, Serra-Prat, Mateu, MD, PhD, MPH
Format Journal Article
LanguageEnglish
Published United States Mosby, Inc 01.12.2008
Subjects
Catheterization, Central Venous - instrumentation
Cross Infection - microbiology
Cross Infection - prevention & control
Disinfection - methods
Equipment Contamination - prevention & control
Equipment Design - instrumentation
Guideline Adherence
Health Personnel
Humans
Infection Control
Infectious Disease
Occupational Health
Risk
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Summary: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.
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ISSN:0196-6553
1527-3296
DOI:10.1016/j.ajic.2008.10.013