Meta-analysis on central line–associated bloodstream infections associated with a needleless intravenous connector with a new engineering design

Tabak, Ying P.; Jarvis, William R.; Sun, Xiaowu; Crosby, Cynthia T.; Johannes, Richard S.

doi:10.1016/j.ajic.2014.08.018

Cited by 26 publications

(13 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…a lack of studies in general, non-randomisation and a lack of peer-reviewed publications being included in the meta-analysis. It is interesting to note that just as the FDA (2010) were issuing their notice regarding positive displacement NCs, data collection on the encouraging effects of positive displacement NCs was being completed by Tabak et al (2014). Thus, the 'improved engineering design' mentioned was actually being used as early as 2006, and five of the seven studies had completed data collection at least 12 months before the FDA released its alert.…”

Section: The Consequences 4: Purchasers Stopped Using Positive Displamentioning

confidence: 99%

“…The Tabak et al (2014) study (on which Jarvis is a coauthor) was a meta-analysis of available studies comparing the MaxPlus®, with those NCs which were in current use; researchers found a lower CLABSI with the MaxPlus® (Tabak et al, 2014). Only one of the available studies found was in a peer-reviewed journal, the remaining six studies were found from conference abstracts.…”

Section: The Consequences 4: Purchasers Stopped Using Positive Displamentioning

confidence: 99%

“…Only one of the available studies found was in a peer-reviewed journal, the remaining six studies were found from conference abstracts. The Tabak et al (2014) paper has limitations, i.e. a lack of studies in general, non-randomisation and a lack of peer-reviewed publications being included in the meta-analysis.…”

Section: The Consequences 4: Purchasers Stopped Using Positive Displamentioning

confidence: 99%

“…A few other recent studies… Tabak et al (2014) claim that the novel study NC in their study, a positive displacement NC, 'has 8 of the 9 desired features outlined by infection control experts' (Tabak et al, 2014). The 'experts' (sic-pleural) referred to was a single author whose opinions were published in a non-peer-reviewed journal (Infection Control Today) (Jarvis, 2010).…”

Section: The Consequences 4: Purchasers Stopped Using Positive Displamentioning

confidence: 99%

See 3 more Smart Citations

Outbreak column 19: needleless connectors (NCs) tales from nine outbreaks

Curran

2016

Journal of Infection Prevention

View full text Add to dashboard Cite

A critical review of historical outbreak reports that are still influencing practice today is presented. These outbreak reports were used as evidence in support of guideline recommendations and of the US Food and Drug Administration's (FDA) advisory notice requiring post-product surveillance for needleless connectors (NC) which have a positive displacement. Guideline recommendations were subsequently changed but not before other authorities had issued recommendations based on the original. All the above led some purchasers to look for different NC designs. The conclusions are that the evidence, as reported, does not support there being an increased risk from positive displacement NCs. Identified in this review were unsubstantiated claims, incompleteness in reporting of specifics, opinions considered as evidence and unexplored outbreak-provoking explanations.

show abstract

Section: The Consequences 4: Purchasers Stopped Using Positive Displamentioning

confidence: 99%

Section: The Consequences 4: Purchasers Stopped Using Positive Displamentioning

confidence: 99%

Section: The Consequences 4: Purchasers Stopped Using Positive Displamentioning

confidence: 99%

Section: The Consequences 4: Purchasers Stopped Using Positive Displamentioning

confidence: 99%

See 2 more Smart Citations

Outbreak column 19: needleless connectors (NCs) tales from nine outbreaks

Curran

2016

Journal of Infection Prevention

View full text Add to dashboard Cite

show abstract

“…Adequate cleaning or need for additional cleaning of the septal access site may be based on the specific design features of the individual NC [2,4,5,7,70,111,129,153,[159][160][161]. New products or technology should be transitioned into a healthcare facility only after a complete evaluation of both the research and the performance of the product to determine the impact of the change on patient outcomes [71,97,98,149,160,[162][163][164][165][166].…”

Section: Why Disinfect?mentioning

confidence: 99%

Disinfection of Needleless Connector Hubs: Clinical Evidence Systematic Review

Moureau¹

2015

Journal of the Association for Vascular Access

View full text Add to dashboard Cite

Background. Needleless connectors (NC) are used on virtually all intravascular devices, providing an easy access point for infusion connection. Colonization of NC is considered the cause of 50% of postinsertion catheter-related infections. Breaks in aseptic technique, from failure to disinfect, result in contamination and subsequent biofilm formation within NC and catheters increasing the potential for infection of central and peripheral catheters. Methods. This systematic review evaluated 140 studies and 34 abstracts on NC disinfection practices, the impact of hub contamination on infection, and measures of education and compliance. Results. The greatest risk for contamination of the catheter after insertion is the NC with 33-45% contaminated, and compliance with disinfection as low as 10%. The optimal technique or disinfection time has not been identified, although scrubbing with 70% alcohol for 5-60 seconds is recommended. Studies have reported statistically significant results in infection reduction when passive alcohol disinfection caps are used (48-86% reduction). Clinical Implications. It is critical for healthcare facilities and clinicians to take responsibility for compliance with basic principles of asepsis compliance, to involve frontline staff in strategies, to facilitate education that promotes understanding of the consequences of failure, and to comply with the standard of care for hub disinfection.

show abstract