Recent literature on pre-filled CVAD flush syringes and infection rate reduction.

[Tim Spencer]

FYI

For those who are interested in CLABSI reduction through the use of
pre-filled flush syringes.

A recent publication in The Journal of Hospital Infection this past May,
focuses on the potential for complication reduction when moving from a
manually filled flush syringe to a pre-filled flush syringe and
ultimately showed a 60% CRBSI reduction when utilizing a pre-filled
flush syringe for maintenance.

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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[Cath Murphy]

Tim

Thanks. These syringes are well used in the US as I am sure you would know and appreciate. They are considered part of the CDC recommendations. This is a small study and the methodology not without limitation. That said it’s always exciting to look at new technologies and further explore their potential for improving patient safety.

Do you think the reduction was due more to standardised care ie. frequent flushing, less handling or something else ? dressing, insertion technique, skin antisepsis? Proving causality and the flip side showing protection is always controversial.

I’m keen to know why you especially found this paper compelling? Also how similar to Australian healthcare settings do you think Italian settings would be? These are the sorts of questions I always have to stop and ask when reviewing reports from the literature.

For the record, I too think that these pre-filled syringes are the way to go and I just wished that as clinicians adopted new technologies we also had capacity, skill and time to invest in undertaking and reporting the much needed research to silence those opponents.

Cheers
Cath
Cathryn Murphy PhD
Executive Director
Infection Control Plus Pty Ltd
http://www.infectioncontrolplus.com.au
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FYI
For those who are interested in CLABSI reduction through the use of pre-filled flush syringes.
A recent publication in The Journal of Hospital Infection this past May, focuses on the potential for complication reduction when moving from a manually filled flush syringe to a pre-filled flush syringe and ultimately showed a 60% CRBSI reduction when utilizing a pre-filled flush syringe for maintenance.

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]

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[Claire Rickard]

Thanks Cath and Tim

“Without randomisation, there can be no causation”. The Bertoglio study is
very interesting but we *DEFINITELY and URGENTLY *need an *RCT *on this
topic, as well as all the many other unknowns in flushing …”how much?,
how often? technique?” etc. etc.

It *sickens *me that about 30% of PIVCs fail (infiltrate, occlude,
phlebitis, fall out), yet these are vital devices that we use EVERY day
(well in the wards anyway :D), and why have we never bothered to do RCTs on
flushing, which is probably at least 50% of the problem (the others being
dressings and securement, site and device selection, inserter
competence…etc)??

The Griffith IVAD group have recently compared prefilled versus manual
syringes in the simulated nursing labs and we were quite impressed with
them (disclosure: we had funding support from the manufacturer). This was
led by Dr Samantha Keogh and has been accepted for publication –
unfortunately the journal in question has a looong lag time and it will not
be published until 2014).

Again, a lab study is not an RCT (although helpful in designing one). But
you will be pleased to know that we plan to kick off with a pilot RCT in
QLD early next year, and then hopefully a multi-site in 2015->

OK off the soapbox now….PM me for more lowdown

Best regards, Claire

*Professor Claire Rickard RN PhD*
c.rickard@griffith.edu.au | +61 7 3735 6460 | Skype: clairexm1 | Twitter:
IVAD_Research |
http://www.griffith.edu.au/health/centre-health-practice-innovation/research/acute-critical-care/intravascular-devices

Intravascular Access Device Research Group | NHMRC Centre of Research
Excellence in Nursing Interventions | Griffith Health Institute | Visiting
Prince Charles Hospital

Research frequently takes me off campus. Please contact Jenny Chan 3735
5406 *j.chan@griffith.edu.au* or
Jo.Wright@griffith.edu.au 3735 4886 with any urgent enquiries.

*It’s nice to be important, but it’s more important to be nice. John Cassis.
*

On 2 August 2013 18:18, Cath Murphy wrote:

> Tim****
>
> ** **
>
> Thanks. These syringes are well used in the US as I am sure you would know
> and appreciate. They are considered part of the CDC recommendations. This
> is a small study and the methodology not without limitation. That said its
> always exciting to look at new technologies and further explore their
> potential for improving patient safety.****
>
> ** **
>
> Do you think the reduction was due more to standardised care ie. frequent
> flushing, less handling or something else ? dressing, insertion technique,
> skin antisepsis? Proving causality and the flip side showing protection is
> always controversial. ****
>
> ** **
>
> Im keen to know why you especially found this paper compelling? Also how
> similar to Australian healthcare settings do you think Italian settings
> would be? These are the sorts of questions I always have to stop and ask
> when reviewing reports from the literature.****
>
> ** **
>
> For the record, I too think that these pre-filled syringes are the way to
> go and I just wished that as clinicians adopted new technologies we also
> had capacity, skill and time to invest in undertaking and reporting the
> much needed research to silence those opponents.****
>
> ** **
>
> Cheers****
>
> Cath****
>
> Cathryn Murphy PhD****
>
> Executive Director****
>
> Infection Control Plus Pty Ltd****
>
> Ph: +61 428 154 154****
>
> http://www.infectioncontrolplus.com.au****
>
> [image: Description: twitter logo] [image:
> Description: FB logo] [image:
> Description: icp icon] ****
>
> ** **
>
> *From:* ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] *On
> Behalf Of *Tim Spencer
> *Sent:* Friday, 2 August 2013 15:54 PM
> *To:* AICALIST@AICALIST.ORG.AU
> *Subject:* Recent literature on pre-filled CVAD flush syringes and
> infection rate reduction.****
>
> ** **
>
> FYI ****
>
> For those who are interested in CLABSI reduction through the use of
> pre-filled flush syringes.****
>
> A recent publication in The Journal of Hospital Infection this past May,
> focuses on the potential for complication reduction when moving from a
> manually filled flush syringe to a pre-filled flush syringe and ultimately
> showed a 60% CRBSI reduction when utilizing a pre-filled flush syringe for
> maintenance. ****
>
> ** **
>
> *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
> [image: 200 yeas logo white.jpg]****
>
>
> _____________________________________________________________________
> This email has been scanned for the Sydney & South Western Sydney Local
> Health Districts by the MessageLabs Email Security System.
> Sydney & South Western Sydney Local Health Districts regularly monitor
> email and attachments to ensure compliance with the NSW Ministry of
> Health’s Electronic Messaging Policy.****
>
> Messages posted to this list are solely the opinion of the authors, and do
> not represent the opinion of ACIPC. ****
>
> Archive of all messages are available at http://aicalist.org.au/archives- registration and login required.
> ****
>
> Replies to this message will be directed back to the list. To create a new
> message send an email to aicalist@aicalist.org.au ****
>
> To send a message to the list administrator send an email to
> aicalist-request@aicalist.org.au. ****
>
> You can unsubscribe from this list be sending ‘signoff aicalist’ (without
> the quotes) to listserv@aicalist.org.au****
> Messages posted to this list are solely the opinion of the authors, and
> do not represent the opinion of ACIPC.
>
> Archive of all messages are available at http://aicalist.org.au/archives- registration and login required.
>
> Replies to this message will be directed back to the list. To create a new
> message send an email to aicalist@aicalist.org.au
>
> To send a message to the list administrator send an email to
> aicalist-request@aicalist.org.au.
>
> You can unsubscribe from this list be sending ‘signoff aicalist’ (without
> the quotes) to listserv@aicalist.org.au
>

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[Ruth Barratt]

Our DHB hospital sites have now introduced these pre-filled saline
syringes here in New Zealand.

Cheers

Ruth

Ruth Barratt RN, BSc, MAdvPrac (Hons)

Clinical NurseSpecialist Infection Prevention and Control

:: ruth.barratt@cdhb.health.nz

(: + 64 3 3640 083 or ext.80083

: 0275 263175

Level 5, Riverside Building

Christchurch Hospital | Private Bag 4710, Christchurch

Clean Hands Save Lives!

Behalf Of Tim Spencer
flush syringes and infection rate reduction.

FYI

For those who are interested in CLABSI reduction through the use of
pre-filled flush syringes.

A recent publication in The Journal of Hospital Infection this past May,
focuses on the potential for complication reduction when moving from a
manually filled flush syringe to a pre-filled flush syringe and
ultimately showed a 60% CRBSI reduction when utilizing a pre-filled
flush syringe for maintenance.

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

_____________________________________________________________________
This email has been scanned for the Sydney & South Western Sydney Local
Health Districts by the MessageLabs Email Security System.
Sydney & South Western Sydney Local Health Districts regularly monitor
email and attachments to ensure compliance with the NSW Ministry of
Health’s Electronic Messaging Policy.

Messages posted to this list are solely the opinion of the authors, and
do not represent the opinion of ACIPC.

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