Just to clarify, the Hopkins experience wasn't from split septum to mechanical. 
 It was from mechanical non-positive pressure to a positive pressure device.  
We went back to the non-positive pressure device and saw the drop in our CRBSI 
rate.  Our non-positive pressure needleless device is not split septum.

Beverly Reynolds, RN, MBA
Nurse Manager, Vascular Access Team
The Johns Hopkins Hospital
410-614-1895

>>> Lynn Hadaway <[EMAIL PROTECTED]> 04/08/06 1:57 PM >>>
You are a little ahead of the game by asking for information that 
does not exist yet. We know that several hospitals are reporting a 
higher rate of CRBSI after switching from a split septum device to a 
mechanical valve. Some have then switched back to a split septum and 
found the rate of CRBSI went back to the original level.

To my knowledge there is no real clinical studies (randomized, 
prospectice controlled clinical trials) that have been done on the 
positive pressure valves. So we don't have hard data on their 
effectiveness with catheter lumen occlusion.

We also do not know yet if the rise in infection rates is due to the 
fact that nurses were not cleaning the mechanical valves or is there 
something about the design of these devices that prevents adequate 
cleaning. I have personally witnessed many times within the past year 
when nurses were going to hook up tubing to a mechanical valve 
without any cleaning.

So no one has issued any guidelines, recommendations or standards to 
avoid using any type of needleless connector. Much more research is 
needed. Lynn

At 2:14 PM -0400 4/7/06, Mary M. Maskell Amirault wrote:
>Can someone send me in the right direction for the latest info on
>infections and effectiveness of positive pressure valves for central
>lines.  Are caps not to be used at all to cover ports?   Thanks
>
>
>
>
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Lynn Hadaway, M.Ed., RNC, CRNI
Lynn Hadaway Associates, Inc.
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