IV Needleless Connectors and Infection Risk

It’s an inevitable part of medicine that changes in technology have unintended consequences — and that not all of them are favorable consequences.

One example is the implementation of needleless connectors for IV catheters. Designed to protect healthcare workers against accidental needlesticks, these IV connectors are used hundreds of millions of times in the US every year.

However, the same connectors are also proving to be a source of potentially dangerous central line associated bloodstream infections (CLABSIs).

Gregory Schears, M.D., a widely published critical care specialist and the physician liaison to the PICC team at the Mayo Clinic in Rochester, Minn., spoke on this topic at a meeting earlier this summer sponsored by the Joint Commission.

The prestigious and influential Joint Commission, which is the primary accreditor of healthcare facilities in the US, built its annual conference around the theme of “Come Together: A Gathering of Leading Ideas in Quality and Safety.” Dr. Schears’ talk was titled “Needleless Connectors: Where Did We Go Wrong and How Do We Make It Right?”

He began his talk by tracing the history of needles and needle-safety technology in medicine. While needleless IV connectors are very effective at protecting healthcare workers, he said, they introduce new levels of risk to patients.

“We have gone into a series of unintended consequences where what was right for the healthcare worker now may be harmful to the patient,” he said. Safety technology has largely solved the problem of accidental needlesticks during the delivery of infusion therapy, but he added: “Our responses with needleless connectors have jeopardized patient care because of the increasing risk of infection.”

How to solve this dilemma?

Dr. Schears and others are investigating the possibility that passive technologies — such as an inexpensive, twist-on disinfection cap to protect and disinfect needleless connectors between line accesses — might be part of the solution.

“We probably need to look to passive technologies such as this to help us out,” he said. His research is exploring “the question of what we can do, to help reduce colonization and subsequent infections that are associated with needleless connectors.”

Dr. Schears will be speaking about his research, at the upcoming annual conference of the Association for Vascular Access in early October. He describes his research in a brief video on disinfection caps, which you can view as part of this blog.

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