Needle-free devices: keeping the system closed

Abstract

Health professionals are under increasing pressure to reduce costs while ensuring patient safety. As the number of vascular access devices (VADs) used in health care continues to increase, there is a need to reduce the complications of infection and occlusion associated with them. Needle-free devices (NFDs), also known as needleless connectors, have been available since the early 1990s and the type and variety of these devices has continued to develop. As well as the original aim of NFDs to maintain a closed system and to reduce the risk of needlestick injuries and blood spillage, NFDs are now designed with the aim of improving clinical outcomes by reducing the common complications of infection and catheter occlusion. As there are a number of NFDs available with specific designs, it is imperative that health professionals have an understanding of the different types and functions. This article provides an explanation of NFD design and functions and guidance and information about their benefits, as well as advice on preventing complications associated with their use.

Right Hub Disinfection for Compliance

“…Once the disinfectant has been selected to decontaminate the hubs and NFC, the disinfection technique needs to be decided upon; currently there is no defined best method (Zhang et al 2016). There are two methods to decontaminate the hubs and NFC: active disinfection and passive disinfection (Curran 2016;Kelly et al 2017).…”

“…Active disinfection is performed using a wipe to mechanically loosen the microorganisms allowing the disinfectant to destroy the microorganisms (Curran 2016). This procedure is often referred to as 'scrubbing the hub' (O'Grady et al 2011; Cameron-Watson 2016; Kelly et al 2017). Regardless of the disinfectant solution, the time spent on disinfection of the hub or NFC is deemed the most important (Moureau and Flynn 2015).…”

“…These disinfection caps contain a sponge impregnated with alcohol that can be attached to the NFC, thus protecting the access point from contamination as well as providing disinfection (Flynn et al 2015;Cameron-Watson 2016;Curran 2016). These disinfection caps are single-use items and must be changed following each use (Sweet et al 2012;Kelly et al 2017).…”

“…In one study, the use of disinfection caps was associated with a 40% decrease in central line-associated bloodstream infections (Merrill et al 2014). In addition, the use of a disinfection cap provides a standardised approach to disinfection (Curran 2016;Kelly et al 2017).…”

Right Evaluation of Products and Compliance Measures

“…Since their introduction, the range of needle-free connectors (NFCs) has exploded, and there is now a vast array of NFCs with various characteristics available. These numerous branded products also vary in their design and function (Kelly et al 2017). The differences include:…”