Re: Needleless IV admin sets

[Wishart, Michael]

Hi Wendy

This is still very controversial area, as there isnt much good data available in the way of controlled trials. In my personal experience, it seems that positive pressure mechanical valves are more problematic from a possible colonisation point of view than leur activated valves. However, it is not all clear cut, as differing devices seen to have differing risks, possible due to device design and / or local practice factors. For instance, a device with an easily swabbable valve top may be much less prone to contamination and valve colonisation than a valve with a difficult to swab top, particularly if staff are not meticulous in swabbing valves prior to access.

The patient risk factors are also very important. You may not see an increase in line-associated bacteraemia in a general surgical population if you implement a certain access system, but another site using these systems in haematology patients may see a huge rise in bacteraemia, as the patient population is much more susceptible. Remember too that line-associated bacteraemias are generally low incidence, and any slight increases may take a while to detect over time in smaller patient populations.

In my opinion, the current best way to handle these IV access items is to do a literature search on the products you want to trial, and see if what has been published. Also, contact sites that have trialled or implemented the devices. Dont rely on the supplier glossy brochure info! But do ask suppliers to give you information on other facilities that have implanted the devices.

Sometime a prolonged trial is the only way to see if these items could cause spikes in bacteraemia in a specific facility and patient population. But always ensure any trial includes very good education on the staff using and accessing the devices.

Hope this is useful.

Cheers

Michael

Michael Wishart | GPH – Infection Control Coordinator

GPH – Quality & Safety Unit (Infection Control) | Greenslopes Private Hospital
Newdegate Street, Greenslopes QLD 4120
t: 07 3394 7919 | f: 07 3394 7985
e: WishartM@ramsayhealth.com.au | w: http://www.ramsayhealth.com.au

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