Course Access
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Michael Wishart
Infection Control Coordinator
St Vincent's Private Hospital Northside & St Vincent's Private Hospital Brisbane
Brisbane, QLD
michael.wishart@svha.org.auIn addition to other comments provided I would refer AICA List users to this InN Press article soon to be published in AJIC. Hopefully it adds further clarity regarding these devices.
Btaiche, I. F., D. S. Kovacevich, et al. “The effects of needleless connectors on catheter-related bloodstream infections.” American Journal of Infection Control In Press, Corrected Proof.
Needleless connectors, including the standard split septum and the luer-activated mechanical valve connectors, have been introduced into clinical practice to eliminate the risk of needlestick injuries by avoiding the use of needles when accessing the intravascular catheters. Negative and positive displacement mechanical valves have been associated with increased rates of catheter-related bloodstream infections as compared with split septum connectors. Based on available data, split septum connectors should be preferentially used instead of mechanical valves. Adequate disinfection by scrubbing the access port preferably with chlorhexidine is recommended to minimize the risk of catheter microbial contamination along with proper infection control practices. Large prospective randomized clinical trials are needed to evaluate further the possible causes and effects of different types of mechanical valve needleless connectors on bloodstream infections.Assoc. Prof Cathryn Murphy RN PhD CIC
Managing Director
Infection Control Plus Pty Ltd
PO Box 106
West Burleigh 4219
Queensland
AUSTRALIA
Ph +61 7 5520 1569
Fax + 61 7 5520 1476
Mob +61 428 154 154
http://www.icp.au.comFrom: AICA Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Michael Wishart
Sent: Monday, 24 January 2011 17:13
To: AICALIST@AICALIST.ORG.AU
Subject: [AICA_Infexion_Connexion] Fwd: [asid-ozbug] Bungs on PICCs[Cross-posted from OzBug with permission on behalf of Tony Allworth – Moderator. I will copy any list replies to him]
A question has been raised that I would appreciated consolidated opinion on (I expect total consensus as usual): We have traditionally left the positive displacement valves (“bungs”) on PICCs from the time they go in unless there is obvious blood build-up or other contamination. The basis of this is to maintain a closed system to minimise infection. It has been pointed out that the positive displacement valves according to the manufacturer should be changed either after a certain number of accesses or time frame eg 3 days. When asked for the rationale for this no answer has been forthcoming. I can find no help in the literature. I am concerned that changing them “routinely” will compromise the microbial integrity of the system.What do others do, and think we should be advising?
Cheers,
Tony Allworth
Dr Tony Allworth
Director, Infectious Diseases
Royal Brisbane & Women’s Hospital(No vested interest in PICCs or bungs)
Messages posted to this list are solely the opinion of the authors, and do not represent the opinion of AICA.
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