IV connector may help eliminate catheter-related blood infections

The study, published in the Summer 2012 issue of the Journal of the Association for Vascular Access (JAVA), compared data for RyMed Technologies’ InVision-Plus? neutral-pressure connector to data for the cancer center’s previous negative-pressure IV connector. An IV connector is a crucial device that helps provide intravenous therapy to patients by connecting tubing to catheters.

“Our study suggests that use of a properly designed IV connector is more important in preventing bloodstream infections than has previously been thought,” said author Brenda Caillouet BSN, MPH, CRNI. “Many institutions continue to use connector designs that are associated with high rates of CRBSI. I hope this study will make a difference in hospitals’ choices of IV connectors.”

With negative-pressure connectors, a backflow of blood into the connector – called “blood reflux” – occurs when tubing or a syringe is disconnected from the device. This makes it difficult to completely flush the blood from the connector, which can lead to bacteria colonization and bloodstream infection. There is no apparent blood reflux with RyMed’s neutral-pressure connector, which reduces the risk of a bloodstream infection.

Preventing CRBSI is particularly crucial with cancer patients. The infections are fatal in 12-25% of hospital patients in general. Cancer patients often have compromised immune systems, thus making them more prone to infection.

The switch in connectors documented in the study was done to determine if the cancer center’s CRBSI rates could be further reduced by using the neutral-pressure connector. The study design was quantitative and quasi-experimental.

Study results were obtained by ­comparing prospective data from use of the neutral-pressure connector to retrospective data from use of a negative-pressure, split-septum (SS) device.­ The center first conducted an initial clinical trial of the neutral-pressure device, where they found that the CRBSI rate was 90% less than the infection rate associated with the negative-pressure connector.

After the initial trial, the connector was implemented institution-wide for inpatient and outpatient units. Then, the first six months of data with the neutral-pressure device were compared to the previous six months of data with the SS connector. There were zero CRBSIs with the neutral pressure connector, while the CRBSI rate for the SS connector was 2.24/1,000 catheter days.

Caillouet believes that certain features of the neutral-pressure connector, such as an independent microbial barrier and smooth, gapless septum, contributed to the study’s positive results.

These factors help prevent contamination of the intraluminal pathway – that is, the “lumen” or fluid pathway inside the IV catheter. The desMujer