HI,
I have a quesiton that keeps coming up in our facility, and I'm having a hard time finding good evidence for which way to go. Reading the CDC guidelines, i feel that they are more inpatient specific.
How often should needleless connectors be changed in an ambulatory setting? May of our patients go home with a CVAD in place, and are in the facility for their medication every 3 weeks. They are taught to flush and lock the lines themselves, but the connectors are only changed when they are here, sometimes it is monthly.
The manufacturer of the connectors we use recomend weekly, even if not in use, and our policy states to change them monthly.
Is there reccomendations of best practice is this situation?
thanks
This is one of those issues that has not been researched. The CDC states to change them on the same frequency as continuous IV set changes. INS standards do not recommend a time. In my opinion, a month is faaaaarrrrrr tooooo long!! I would never allow one to go beyond a week. There is some evidence that biofilm growing inside needleless connectors reaches a steady state within 5 days. After that the growth of biofilm equals the breakage and the brekage is what produces BSI. So I would say all need to be change at least every 7 days but preferably no longer than 4 days. Lynn
Lynn Hadaway, M.Ed., RN, BC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
If they have a CVAD that requires flushing it probably requires dressing changes. Who does the dressing changes? and can the needleless connector be changed then?
Gail McCarter, BSN,CRNI
Franklin, NH
If they have a CVAD that requires flushing it probably requires dressing changes. Who does the dressing changes? and can the needleless connector be changed then?
Gail McCarter, BSN,CRNI
Franklin, NH
Thank you so much for the comments. I agree that a month is too long.
The patients are taught to do their own flushing and locking and dressing changes on the tunnelled lines. We have them come in for that with the PICC lines. The PICC lines are not an issue as we can change the connectors with the dressing changes. We do not want the patients to change their own connectors however.
It causes an issue with staffing, as we have many of these patients, and if we have to start brining them in for cap changes weekly, it is difficult to find chairs and staff for them.