WHAT I LEARNED AT AVA SAVANNAH--RE THE SUBJECT: NEEDLELESS CONNECTORS..............................................
First we heard from Marilyn Hanchett and Dr. Marcia Ryder--They presented visual cross sections of nearly every connector device on the market-- illustrating both the fluid pathway (where there is the potential for bacteria to take up residence in their "nooks and cranies") and the swabbable surface (where both terrain and technique impact the potential for bacteria to thrive)--I asked Dr. Ryder to elaborate on the subject of Biofilm development inside the connector and how blood draws effect the process--She said that Biofilm formation develops immediately and begins farming out germs within 72 hours--(which is why it is good policy/practice to change the connector each time you change administration sets as well if you are sampling frequently because blood does nourish the development of Biofilm)--Then we heard from Drs Maki and Jarvis--I purchased the recording of each of their presentations and have just finished listening to them again in order to refresh my impressions--First Dr Maki spoke extensively about "Line Sepsis"--He spoke of the various sources: skin, fluid, hub manipulation, luminal contaminates (water organisms from showering)--He said that connector technology had "backfired" and that preliminary studies show the flaws with "Valved Needleless Systems" were both with their construction (complicated fluid pathways) and aftercare (improper/inconsistent disinfection of the hub and disregard for cap change regimes)--He recommended a 10-15 second "vigorous scrub" (not a "wipe" or a swipe) and he spoke of looming technology which he called an 'ABC' Antiseptic Barrier Cap (a passive cleansing system that activates each time a connection is made)--Then Dr Jarvis spoke and he dedicated the last 20 minutes of his presentation to the discussion of the "emerging problem of mechanical valve needleless devices"--I encourage everyone to purchase this recording (1-800-747-1426 request order #VA-P21 CRBSI -William Jarvis) and listen to it over and over again and then have the "signifcant clinicians" (Physicians and Nurses) at your institutions listen to it as well--All the evidence is anecdotal, data is abstract and studies observational but Dr Jarvis does not believe "it's chance" that CRBSIs increased everytime any needleless valve was introduced to the CVC system--And lastly at 630AM on Saturday Jan 14 2006 Denise Macklin delivered a passionate presentation about "Neutral Fluid Displacement" and a valve called "Invision-Plus"-- www.rymedtech.com --Technology that speaks to the issue of both "Intraluminal Thrombotic Catheter Occlusion" and CRBSI--LOOK FOR A PLETHERA OF "EVIDENCE BASED" RESEARCH TO EMERGE IN THE NEXT YEAR--See you all in Indianopolis
--
Robbin K. George RN
Vascular Access Resource
Alexandria Hospital Virginia
Robbin K. George RN
Vascular Access Resource
Alexandria Hospital Virginia
