Needleless access devices and PN

[Klintworth, Gemma]

Hi all,
With regard to administration of parenteral nutrition via a central
line, I’m wondering how frequently people recommend that the needleless
access device is changed (if one is used at all in this case).
Thanks,
Gemma
Gemma Klintworth
CLABSI Project Coordinator
Infection Prevention and Healthcare Epidemiology

t 03 90762250 e G.Klintworth@alfred.org.au

Alfred Health
55 Commercial Road
Melbourne VIC 3004
PO Box 315 Prahran
VIC 3181 Australia

Alfred Health incorporates The Alfred, Caulfield Hospital and
Sandringham Hospital
http://www.alfredhealth.org.au

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[Michael Wishart]

Hi Gemma

Interesting question. We would not routinely change a needleless access device connected to a cannula / lumen every 24 hours, but we would change any needless access device that was considered part of a ‘line’ every 24 hours (or on completion of TPN) for any ‘lines’ used to administer TPN (or any blood products). Had never really thought about the needleless access devices used to connect the line to the cannula / lumen, as had always considered those as part of the cannula / catheter, not part of the ‘line’ or ‘giving set’.

Food for thought, though. Is the risk of biofilm in the needleless access device after infusion of lipids, etc higher than the risk of breaking the ‘closed’ system to replace the valve?

Cheers
Michael

Michael Wishart
CNC Infection Control
Holy Spirit Northside Private Hospital
627 Rode Road, Chermside, Qld 4032
t: (07) 3326 3068 | f: (07) 3607 2226
e: Michael.Wishart@hsn.org.au
w:www.holyspiritnorthside.org.au
Please consider the environment before printing this email

Hi all,

With regard to administration of parenteral nutrition via a central line, I’m wondering how frequently people recommend that the needleless access device is changed (if one is used at all in this case).

Thanks,

Gemma

Gemma Klintworth
CLABSI Project Coordinator
Infection Prevention and Healthcare Epidemiology

t 03 90762250 e G.Klintworth@alfred.org.au

Alfred Health
55 Commercial Road
Melbourne VIC 3004
PO Box 315 Prahran
VIC 3181 Australia

[cid:364084200@28022013-0175]

Alfred Health incorporates The Alfred, Caulfield Hospital and Sandringham Hospital
http://www.alfredhealth.org.au

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[Tim Spencer]

Hi Gemma,

As far as I know, there is no specific literature that describes
needlefree caps/valves to be changed specifically in PN patients.

However, that said, going off current international guidelines and
recommendations, I would say a weekly change is justified.

Most PN admin sets are changed at 24hrs (if a 3 in 1 solution) because
of the lipid content.

I see no reason to be changing the needlefree port at 24hrs as that
induces excessive cost as well.

I would maintain a 7 day change period unless clinically indicated to do
so.

I do have current PN European guidelines, so feel free to contact me if
you might like a copy.

Regards,

Tim..

Timothy R. Spencer, RN, APN, DipAppSci, Bach.Health, ICCert.
Clinical Nurse Consultant, Central Venous Access & Parenteral Nutrition
Service

Conjoint Lecturer, South West Sydney Clinical School | Faculty of
Medicine | University of NSW
Dept of Intensive Care, Level 2, Clinical Building, Liverpool Hospital,
Elizabeth Street, Liverpool, 2170, NSW, Australia
Tel (+61) 2 8738 3603 | Fax (+61) 2 8738 3551 | Mob +61 (0)409 463 428 |
Tim.Spencer@sswahs.nsw.gov.au | Timothy.Spencer@unsw.edu.au

Behalf Of Klintworth, Gemma

Hi all,

With regard to administration of parenteral nutrition via a central
line, I’m wondering how frequently people recommend that the needleless
access device is changed (if one is used at all in this case).

Thanks,

Gemma

Gemma Klintworth
CLABSI Project Coordinator

Infection Prevention and Healthcare Epidemiology

t 03 90762250 e G.Klintworth@alfred.org.au

Alfred Health
55 Commercial Road
Melbourne VIC 3004
PO Box 315 Prahran
VIC 3181 Australia

Alfred Health incorporates The Alfred, Caulfield Hospital and
Sandringham Hospital
http://www.alfredhealth.org.au

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any delay in its receipt.

Please consider the environment before printing this email.

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[Klintworth, Gemma]

Hi, thanks for your responses. I agree that changing the needleless
access device every 24 hours and ‘opening’ the system so frequently may
introduce additional risk and would be costly.
For other solutions, we recommend changing the needleless access device
along with continuous infusion administration lines (but no more
frequently than 72 hours) as per the CDC. The issue with TPN lines is
therefore inconsistent with this.
Gemma
Gemma Klintworth
CLABSI Project Coordinator
Infection Prevention and Healthcare Epidemiology

t 03 90762250 e G.Klintworth@alfred.org.au

Alfred Health
55 Commercial Road
Melbourne VIC 3004
PO Box 315 Prahran
VIC 3181 Australia

Alfred Health incorporates The Alfred, Caulfield Hospital and
Sandringham Hospital
http://www.alfredhealth.org.au

CONFIDENTIALITY NOTICE: This email and any files transmitted with it are
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Please consider the environment before printing this email.

________________________________

Behalf Of Tim Spencer

Hi Gemma,

As far as I know, there is no specific literature that describes
needlefree caps/valves to be changed specifically in PN patients.

However, that said, going off current international guidelines and
recommendations, I would say a weekly change is justified.

Most PN admin sets are changed at 24hrs (if a 3 in 1 solution) because
of the lipid content.

I see no reason to be changing the needlefree port at 24hrs as that
induces excessive cost as well.

I would maintain a 7 day change period unless clinically indicated to do
so.

I do have current PN European guidelines, so feel free to contact me if
you might like a copy.

Regards,

Tim..

Timothy R. Spencer, RN, APN, DipAppSci, Bach.Health, ICCert.
Clinical Nurse Consultant, Central Venous Access & Parenteral Nutrition
Service

Conjoint Lecturer, South West Sydney Clinical School | Faculty of
Medicine | University of NSW
Dept of Intensive Care, Level 2, Clinical Building, Liverpool Hospital,
Elizabeth Street, Liverpool, 2170, NSW, Australia
Tel (+61) 2 8738 3603 | Fax (+61) 2 8738 3551 | Mob +61 (0)409 463 428 |
Tim.Spencer@sswahs.nsw.gov.au | Timothy.Spencer@unsw.edu.au
200 yeas logo white.jpg

Behalf Of Klintworth, Gemma

Hi all,

With regard to administration of parenteral nutrition via a central
line, I’m wondering how frequently people recommend that the needleless
access device is changed (if one is used at all in this case).

Thanks,

Gemma

Gemma Klintworth
CLABSI Project Coordinator

Infection Prevention and Healthcare Epidemiology

t 03 90762250 e G.Klintworth@alfred.org.au

Alfred Health
55 Commercial Road
Melbourne VIC 3004
PO Box 315 Prahran
VIC 3181 Australia

Alfred Health incorporates The Alfred, Caulfield Hospital and
Sandringham Hospital
http://www.alfredhealth.org.au

CONFIDENTIALITY NOTICE: This email and any files transmitted with it are
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disclosure, copying, distribution or taking any action in reliance on
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transmission of the information contained in this communication or for
any delay in its receipt.

Please consider the environment before printing this email.

_____________________________________________________________________
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Health Districts by the MessageLabs Email Security System.
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[Richard Bartolo]

Hi All,
Is anyone use needle free connector in haemodialysis? I cant seem to find any in Australia.

Richard Bartolo
Manager Infection Prevention

Western Health
Gordon Street, Footscray VIC 3011
Tel. 03 8345 6113
Pager. 03 8345 6666 No. 506
Mob. 0438 560 441
Email. richard.bartolo@wh.org.au
Web. http://www.westernhealth.org.au

[cid:image001.jpg@01CE1662.FD7173C0]

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From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Klintworth, Gemma
Sent: Friday, 1 March 2013 9:42 AM
To: AICALIST@AICALIST.ORG.AU
Subject: Re: [ACIPC_Infexion_Connexion] Needleless access devices and PN

Hi, thanks for your responses. I agree that changing the needleless access device every 24 hours and ‘opening’ the system so frequently may introduce additional risk and would be costly.

For other solutions, we recommend changing the needleless access device along with continuous infusion administration lines (but no more frequently than 72 hours) as per the CDC. The issue with TPN lines is therefore inconsistent with this.

Gemma

Gemma Klintworth
CLABSI Project Coordinator
Infection Prevention and Healthcare Epidemiology

t 03 90762250 e G.Klintworth@alfred.org.au

Alfred Health
55 Commercial Road
Melbourne VIC 3004
PO Box 315 Prahran
VIC 3181 Australia

[cid:673511522@28022013-0027]

Alfred Health incorporates The Alfred, Caulfield Hospital and Sandringham Hospital
http://www.alfredhealth.org.au

CONFIDENTIALITY NOTICE: This email and any files transmitted with it are confidential and intended solely for the use of the individual or entity to whom they are addressed. If you have received this email in error, please notify us by return email and delete all copies in your system. If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution or taking any action in reliance on the contents of this information is strictly prohibited and may be unlawful. Alfred Health is not liable for the proper and complete transmission of the information contained in this communication or for any delay in its receipt.

Please consider the environment before printing this email.

________________________________
From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Tim Spencer
Sent: Friday, 1 March 2013 08:59
To: AICALIST@AICALIST.ORG.AU
Subject: Re: Needleless access devices and PN
Hi Gemma,
As far as I know, there is no specific literature that describes needlefree caps/valves to be changed specifically in PN patients.
However, that said, going off current international guidelines and recommendations, I would say a weekly change is justified.
Most PN admin sets are changed at 24hrs (if a 3 in 1 solution) because of the lipid content.
I see no reason to be changing the needlefree port at 24hrs as that induces excessive cost as well.
I would maintain a 7 day change period unless clinically indicated to do so.
I do have current PN European guidelines, so feel free to contact me if you might like a copy.
Regards,
Tim..

Timothy R. Spencer, RN, APN, DipAppSci, Bach.Health, ICCert.
Clinical Nurse Consultant, Central Venous Access & Parenteral Nutrition Service
Conjoint Lecturer, South West Sydney Clinical School | Faculty of Medicine | University of NSW
Dept of Intensive Care, Level 2, Clinical Building, Liverpool Hospital, Elizabeth Street, Liverpool, 2170, NSW, Australia
Tel (+61) 2 8738 3603 | Fax (+61) 2 8738 3551 | Mob +61 (0)409 463 428 | Tim.Spencer@sswahs.nsw.gov.au | Timothy.Spencer@unsw.edu.au
[cid:image001.jpg@01CE165B.0972DA40]

From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Klintworth, Gemma
Sent: Thursday, 28 February 2013 4:37 PM
To: AICALIST@AICALIST.ORG.AU
Subject: Needleless access devices and PN

Hi all,

With regard to administration of parenteral nutrition via a central line, I’m wondering how frequently people recommend that the needleless access device is changed (if one is used at all in this case).

Thanks,

Gemma

Gemma Klintworth
CLABSI Project Coordinator
Infection Prevention and Healthcare Epidemiology

t 03 90762250 e G.Klintworth@alfred.org.au

Alfred Health
55 Commercial Road
Melbourne VIC 3004
PO Box 315 Prahran
VIC 3181 Australia

[cid:364084200@28022013-0175]

Alfred Health incorporates The Alfred, Caulfield Hospital and Sandringham Hospital
http://www.alfredhealth.org.au

CONFIDENTIALITY NOTICE: This email and any files transmitted with it are confidential and intended solely for the use of the individual or entity to whom they are addressed. If you have received this email in error, please notify us by return email and delete all copies in your system. If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution or taking any action in reliance on the contents of this information is strictly prohibited and may be unlawful. Alfred Health is not liable for the proper and complete transmission of the information contained in this communication or for any delay in its receipt.

Please consider the environment before printing this email.

_____________________________________________________________________
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[Tim Spencer]

TEGO by Mayo Healthcare is available.

Contact your local rep.

http://www.gobmp.com/tego/index.asp

Timothy R. Spencer, RN, APN, DipAppSci, Bach.Health, ICCert.
Clinical Nurse Consultant, Central Venous Access & Parenteral Nutrition Service

Conjoint Lecturer, South West Sydney Clinical School | Faculty of Medicine | University of NSW
Dept of Intensive Care, Level 2, Clinical Building, Liverpool Hospital, Elizabeth Street, Liverpool, 2170, NSW, Australia
Tel (+61) 2 8738 3603 | Fax (+61) 2 8738 3551 | Mob +61 (0)409 463 428 | Tim.Spencer@sswahs.nsw.gov.au | Timothy.Spencer@unsw.edu.au

From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Bartolo, Richard
Sent: Friday, 1 March 2013 9:56 AM
To: AICALIST@AICALIST.ORG.AU
Subject: Re: Needleless access devices and PN

Hi All,

Is anyone use needle free connector in haemodialysis? I cant seem to find any in Australia.

Richard Bartolo
Manager Infection Prevention

Western Health

Gordon Street, Footscray VIC 3011
Tel. 03 8345 6113
Pager. 03 8345 6666 No. 506
Mob. 0438 560 441

Email. richard.bartolo@wh.org.au
Web. http://www.westernhealth.org.au

2010wh_logo

Notice:
This email (and any attachment) is for the exclusive use of the addressee and may contain information that is privileged, confidential or protected by copyrights. If you are not the addressee or the person responsible for delivering this email to the addressee, you must not disclose, distribute, print or copy this email and the contents must be kept strictly confidential. If this email has been sent to you in error, kindly notify us immediately on 03 8345 56113 and destroy the original. Electronic mail is not secure and there is also a risk that it may be corrupted in transmission. It is therefore your responsibility to check this email (and any attachment) carefully and if there are any errors to contact us immediately. We do not accept liability for any loss or damage caused by such lack of security or transmission errors.

From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Klintworth, Gemma
Sent: Friday, 1 March 2013 9:42 AM
To: AICALIST@AICALIST.ORG.AU
Subject: Re: [ACIPC_Infexion_Connexion] Needleless access devices and PN

Hi, thanks for your responses. I agree that changing the needleless access device every 24 hours and ‘opening’ the system so frequently may introduce additional risk and would be costly.

For other solutions, we recommend changing the needleless access device along with continuous infusion administration lines (but no more frequently than 72 hours) as per the CDC. The issue with TPN lines is therefore inconsistent with this.

Gemma

Gemma Klintworth
CLABSI Project Coordinator

Infection Prevention and Healthcare Epidemiology

t 03 90762250 e G.Klintworth@alfred.org.au

Alfred Health
55 Commercial Road
Melbourne VIC 3004
PO Box 315 Prahran
VIC 3181 Australia

Alfred Health incorporates The Alfred, Caulfield Hospital and Sandringham Hospital
http://www.alfredhealth.org.au

CONFIDENTIALITY NOTICE: This email and any files transmitted with it are confidential and intended solely for the use of the individual or entity to whom they are addressed. If you have received this email in error, please notify us by return email and delete all copies in your system. If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution or taking any action in reliance on the contents of this information is strictly prohibited and may be unlawful. Alfred Health is not liable for the proper and complete transmission of the information contained in this communication or for any delay in its receipt.

Please consider the environment before printing this email.

________________________________

From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Tim Spencer
Sent: Friday, 1 March 2013 08:59
To: AICALIST@AICALIST.ORG.AU
Subject: Re: Needleless access devices and PN

Hi Gemma,

As far as I know, there is no specific literature that describes needlefree caps/valves to be changed specifically in PN patients.

However, that said, going off current international guidelines and recommendations, I would say a weekly change is justified.

Most PN admin sets are changed at 24hrs (if a 3 in 1 solution) because of the lipid content.

I see no reason to be changing the needlefree port at 24hrs as that induces excessive cost as well.

I would maintain a 7 day change period unless clinically indicated to do so.

I do have current PN European guidelines, so feel free to contact me if you might like a copy.

Regards,

Tim..

Timothy R. Spencer, RN, APN, DipAppSci, Bach.Health, ICCert.
Clinical Nurse Consultant, Central Venous Access & Parenteral Nutrition Service

Conjoint Lecturer, South West Sydney Clinical School | Faculty of Medicine | University of NSW
Dept of Intensive Care, Level 2, Clinical Building, Liverpool Hospital, Elizabeth Street, Liverpool, 2170, NSW, Australia
Tel (+61) 2 8738 3603 | Fax (+61) 2 8738 3551 | Mob +61 (0)409 463 428 | Tim.Spencer@sswahs.nsw.gov.au | Timothy.Spencer@unsw.edu.au
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From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Klintworth, Gemma
Sent: Thursday, 28 February 2013 4:37 PM
To: AICALIST@AICALIST.ORG.AU
Subject: Needleless access devices and PN

Hi all,

With regard to administration of parenteral nutrition via a central line, I’m wondering how frequently people recommend that the needleless access device is changed (if one is used at all in this case).

Thanks,

Gemma

Gemma Klintworth
CLABSI Project Coordinator

Infection Prevention and Healthcare Epidemiology

t 03 90762250 e G.Klintworth@alfred.org.au

Alfred Health
55 Commercial Road
Melbourne VIC 3004
PO Box 315 Prahran
VIC 3181 Australia

Alfred Health incorporates The Alfred, Caulfield Hospital and Sandringham Hospital
http://www.alfredhealth.org.au

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