Is the reccomendation to change the needless connector with every TPN tubing change or to leave the needleless connector the full 96 hours? If the connector should be changed with tubing changes is this also true for other fat emulsions (Propofol, etc.) with an every 12 hours tubing change? INS says the change the needleless connector no more frequently than every 96 hours, but for continuous infusion change the connector with any administration set changes. That seems as thought the connector should be changed every 24 with TPN tubing changes and every 12 with propofol etc. but it is concerning to me to be opening the port up that frequently. What are your facilities doing?
Are you talking about PN that is continuous or cyclic? Hospital or home care? Nurse or patient doing the disconnection? Needleless connectors are only indicated for intermittent infusions. So take the NC out of the system for continuous infusions and do not use them as they serve no purpose for any continuous infusion.. Use regular precautions like closing catheter clamp to change admin set every 24 h. Plus they can add to the risk of BSI. For intermittentm like cyclic PN especially when disconnected by a patient, there are no studies on when to change the NC. This is a decision your facility has to make based on your risk factors and CLABSI rates now. You can choose to change q24h with set or q96h or weekly. No evidence either way.
Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
Thank you Lynn! Can you direct me to the resource that shows needless connectors are not indicated for continuous infusions?
INS Standard #34 Needleless Connectors
Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861