Just as a note - re-education was done for staff throughout the institution. One of the reasons this was discovered was because the pediatric ICUs were undergoing an intensive PI related to infection control practices and in every other area were these efforts were undertaken, a reduction in infection rates was seen. In these units, it was going up - which didnt' make any sense. One of the Infection Control staff had just attended a conference, where this had been presented. So, the Hopkins staff began to look at the timing of the increase in infections and discovered that it coincided with our change to the positive pressure valve. As soon as we took it away, the infection rate dropped. Hopkins is a fairly large facility so the thought is - that if training and retraining does work for the masses, then the device is probably not user friendly and not a good choice for this environment. From the info that I have read, (and I also believe Lynn stated this on the list! serv recently) that this increase in infection rates has been contributed to several different valves - it is not isolated to one valve.
Beverly Reynolds, RN, MBA Nurse Manager, Vascular Access Team The Johns Hopkins Hospital 410-614-1895 >>> <[EMAIL PROTECTED]> 01/16/06 11:03 PM >>> Well Peter you hit the question exactly. Drs Maki and Jarvis did not mention a specific brand. The word from valve manufacturers seems to be blaming weaknesses in the fluid path seal that allow liquid contaminates in. I heard practioners talking about poor staff education and/or compliance with swabbing as a possible cause. But truly we don't know that there is a problem. There was no data given as to type of valve or how it was used or how staff was educated. There was no data about a trailing a different valve to see if there was a difference. and no mention was made as to the reeducation of staff and a trail to follow that. So I feel we have many more questions to answer before we start tossing our valves in the can. But certainly it is interesting and worthy of note. I hope that everyone will begin taking a close look at the numbers in their facilities. Perhaps a few quick small trials to see if any trends emerge. Tony In a message dated 1/15/2006 8:14:56 P.M. Central Standard Time, [EMAIL PROTECTED] writes: Thank you Tony for keeping us all up to date with the conference!! A question though is burning in my mind. I don't recall, from the disscussion we had on the list this spring/summer, about a brand specific needless connector being responsible for for the increase in CRBSI. So could you please tell us which connector(s) are in question? What is the reason that belies a particular valve design, that makes it prone to causing CRBSI? Peter Marino RN BSN ----- Original Message ----- From: [EMAIL PROTECTED] (mailto:[EMAIL PROTECTED]) Date: Sunday, January 15, 2006 12:06 am Subject: AVA conference, DAY 3"The topic was needleless connectors. They discussed the qualities of a needleless device that would contribute to maintaining a safe fluid pathway. The premise is that the association of increased catheter related infections with valves is likely a brand specific problem and not a wholesale problem of the device category as Drs Maki and Jarvis's data might have led one to believe." > Tony West, RN, CRNI > Healix, Inc. > Email: [EMAIL PROTECTED] or [EMAIL PROTECTED] > SMS: [EMAIL PROTECTED] > Cell: 214-674-4848
