I was reading through the giant SIOP document @markshirran posted and came across this study:
DECREASED CENTRAL LINE–ASSOCIATED BLOODSTREAM INFECTION (CLABSI) RATE AFTER IMPLEMENTING CUSTOM MADE I.V SYSTEM, NEEDLE FREE CONNECTOR AND INTENSIVE TRAINING OF THE NURSE STAFF
L. Vandueren , M.J. Thelissen, V. Cossey , M. Neyens, V. Labarque, H. Segers, S. Jacobs, A. Uyttebroeck, M. Renard
University Hospitals Leuven, Department of Paediatric Haematology and Oncology, Leuven, Belgium
University Hospitals Leuven, Department of Hospital Hygiene, Leuven, Belgium
University Hospitals Leuven, Department of Neonatology, Leuven, Belgium
University Hospitals Leuven, Paediatric Hemato-Oncology, Leuven, Belgium
Central venous lines are an essential instrument in treating paediatric hemato-oncology patients.
Preventing and decreasing CLABSI is a major challenge.
To decrease the high rate of CLABSI in a paediatric hemato-oncology department action was taken by profound reorganization of the IV system, an intensive training of the nurse staff and by introducing the MicroClave®, a needle free connector.
In 2012 it was clear that the number of CLABSI in the paediatric hemato-oncology department was too high in comparison with similar centers: 7.6 CLABSI/ 1,000 tunneled catheter days (National Healthcare Safety Network (NHSN) mean 2.3) and 5.74/1,000 port-a-cath days (NHSN mean 1.7).
To reduce this high rate of CLABSI an action plan was worked out: implementation of the Clear
MicroClave®, a needle free connector system; implementation of a custom made closed IV system, with less risk of introducing infection in the system and intensive training session of the nursing staff.
As there was already a lot of experience with the needle free connector in the intensive units in the
hospital and as the system meets the recommendations, as published in the recent guidelines of CDC, the choice for the MicroClave® Clear system was obvious.
The whole process was intensively supported by the infection control department. Besides an intensive training of the whole nursing staff was set up, also at the end, all nurses mandatory had to pass a test.
These actions resulted in a dramatic decrease in CLABSI, from 7.6/1,000 tunneled catheter days to 0 at the end of 2015, and from 5.74/1,000 port-a-cath days to 0 at the end of 2015.
Intensive staff training, introduction of a new IV prepared system and the introduction of a needle free system resulted in a dramatic fall of central line infections on a paediatric hemato-oncology ward.
I had a look at the product data sheet at: http://icumed.com/products/infusion-therapy/needlefree-iv-connectors/microclave-clear.aspx
And it says:
- Effectively clears blood and blood residual with low flush volumes.
- Does not require a change in clinical practice or technique.
- Saline flush option can eliminate the use of heparin.
- Minimal blood reflux in the catheter tip.
Use of heprin always bothered me with our central line, luckily our hospital uses a much lower dose than many do and staff a trained to properly discard the heprin on every access. Yet sometimes anesthetist would just push the heprin in and it always made me super uneasy.
It looks like somehow this product allows you to eliminate use of heprin and use much smaller flushes. needle-less access to the line makes it lots safer and significantly less fluid is stuck inside the connector.
Does anyone use these connectors? Is this something I should mention to my hospital?