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.

Get Infected, Stay in the Hospital

A new report on healthcare-acquired infections (HAI’s) tallies up their financial and mortality toll. The report confirms what’s already been known – patients who get an infection while in the hospital have to stay in hospital longer – and also reveals it’s worse than many of us thought.

Turns out that adults who get an HAI while in the hospital had to stay in the hospital an average of 19 days longer than those who didn’t get an infection, according to the Agency for Healthcare Research and Quality.

Moreover, the report on 2007 data shows those adults are six times more likely to die while in the hospital. Not surprisingly, costs associated with an HAI were $43,000 higher per patient.

Amid these grim numbers there was a bit of good news: AHRQ reported a decline in the rate of infections among medical and surgical discharges after a peak in 2004 and 2005.

More on this from Infection Control Today magazine at http://tinyurl.com/2g45qlc, and from AHRQ’s new statistical brief, “Adult Hospital Stays with Infection Due to Medical Care, 2007” PDF at http://www.hcup-us.ahrq.gov/reports/statbriefs/sb94.pdf.

Excelsior, Novian Added as New Clients

We’re happy to report that even in the economic downturn, we’ve added two new clients:

* Excelsior Medical is a leading maker of prefilled catheter flush syringes. The company is also launching an exciting new technology called SwabCap™. This product promises to pioneer more effective prevention of potentially deadly catheter-related bloodstream infections.

SwabCap provides passive, verifiable disinfection of the top and threads of luer access valves. These valves are a critical part of providing IV medication and nutrition. Both the Joint Commission and SHEA/IDSA Compendium have new guidelines calling for hospitals to have a specific disinfection protocol– meaning Excelsior expects strong demand for SwabCap as part of the company’s focus on preventing intra-luminal contamination of catheters. http://www.ExcelsiorMedical.com

*Novian Health makes the Novilase™ laser ablation device to treat fibroadenomas of the breast. These non-cancerous lumps are a troubling breast health problem for many women. Novilase provides a minimally invasive alternative to surgical lumpectomy, with no scarring and less infection risk. Novilase is FDA-cleared for treating fibroadenomas. http://novianhealth.com