We have noticed that just lately the max-plus end cap is coming off the line when the RN is flushing the line. She screws the flush on the line and the entire flush and max-plus is popping off the line. Has anyone noticed this happening to them? The are using the pulse method to flush the line also. The director of nursing has asked me to inquire about this problem.
Will the lumen flush without resistance when this needleless connector has been removed? If so, I would say this is a product problem. If you are meeting obstruction as detected by resistance from a manual flush, then I would say this is a flushing technique issue. What is the sequence being used for flushing, clamping, and disconnecting. MaxPlus is a positive displacement connector, therefore the one and only correct sequence is
1. flush (I do not believe that the pulsatile method is necessary but that is another discussion)
2. leave a small amount of fluid in the final syringe if using traditional syringes. There are at least 3 brands of prefilled syringes designed to overcome syringe-induced reflux, but many flush syringes batch-filled in your pharmacy and several brands that are aseptically filled will cause reflux due to compression of the plunger rod gasket.
3. disconnect the syringe from the connector
4. then close the catheter clamp
If the nurses are emptying the syringe and/or closing the clamp, then disconnecting the syringe, the positive displacemet is not occuring and there is blood reflux leading to a clotted lumen.
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
We had the same issue when we started to use them. The problem was diagnosed by the Co. but we didn't agree with their theory. Because of the frequency of them loosening and the safety issue with chemo admin, we changed to a different co.