Beverly,
Were there any design features of the positive pressure cap you
trialed -other than positive fluid displacement - that perhaps made
it more difficult to swab thoroughly and may have contributed to the
increase in infection?
/Martha Pike
On Apr 11, 2006, at 1:26 PM, Beverly Reynolds wrote:
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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