The thing that is so interesting here is the fact that at your facility
this is not split septum vs mechanical but between two valves are both
luer access and the problem one was the positive pressure one. The
cleaning of the cap is the same for each of these ( I think you do need
to be a little more deliberate when swabbing the luer accepting
devices.) The fact that you had a lot of years of good results with a
non-pp luer accepting device is very encouraging to me.
Penny
On Jan 17, 2006, at 6:30 AM, Beverly Reynolds wrote:
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
