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 Why are you using a needleless connector inside an administration system when continuous infusion is running? SHEA 2014 guidelines now state this use is an unknown issue. I think it adds risk of infection, adds an unnecessary connection point, and adds costs. If you insist on using it for continuous infusions, then it should be changed at the same interval as the administration set. For TPN, CDC says change the set at 96 hours. For lipids, change at 24 hours. If you are piggybacking lipids, there will always be a short segment of the primary set exposed to lipids and not changed daily. This is also an unresolved and un-researched question. Lynn

 The growth of needleless connectors in the past 15 or so years is the driving force behind use of a needleless connector in a system that is infusing continuous fluid. Prior to that, the administration set was always connected directly to the catheter hub. Some started to use the NC stating that they could change the set without opening the catheter hub. This is not true because CDC plainly states that the NC must be changed at the same time as the admin set. There is a question between CDC and ASPEN for changing the admin set for all PN solutions. 2-1 PN should be changed every 72 hr per CDC, lipds set every 24 hours. ASPEN says the whole thing should be changed at 24 hours. Like I said, SHEA Compendium 2014 on CLABSI now states this use of an NC for continuous infusion is an unresolved issue. Once something is recognized as unresolved this attention usually drives research to answer the question but we don't have the research yet. Lynn