Does anyone having any fedback or info regarding neutral caps for Piccs and other central lines? More clotting or less, more infections or less? We are going to trial them and am trying to get any info I can. Thanks Susan
The InVision-Plus® Neutral® connector system by RyMed Technologies is available at www.rymedtech.com. This site includes poster presentations by Karen White - reduction in occlusions, Sophie Harnage reduction in CRBSI, and Guy Cook 93% - 99% reduction in bacterial colonization plus other documentation. I have been involved with connector technology for almost two years. In order to decrease occlusions, repeated reflux episodes associated with connection (positive pressure connectors) or disconnection (split septum or non positive pressure Luer) must be eliminated. With each reflux episode, fibrin builds up on the walls of the catheter.While there will always be some reflux that occurs with breathing, suctioning, coughing etc. the repeated reflux with usage can be eliminated when using the InVision-Plus® Neutral® connector.It has zero fluid movement with connection or disconnection.While eliminating occlusion is a complex issue, by eliminating mechanical reflux can decrease thrombotic episodes when coupled with good catheter flushing regimens.Recently at the AVA meeting in Phoenix Marcia Ryder discussed that a straight fluid pathway with a low priming volume were important connector design factors in minimizing bacterial colonization of the connector.While these features minimize bacterial adhesion, it is also important to minimize bacterial entry into the fluid pathway.To do this the septum surface must be swababble and the fluid pathway protected.The new designed InVision-Plus® Neutral® connector by RyMed Technologies has a protected fluid pathway, zero fluid displacement with connection or disconnection, and can be used with Saline only. It has a swabbable septum (bug glow testing at rymedtech.com) It has a straight fluid pathway, zero deadspace, and 0.027 mL priming volume. It has two independent microbial barriers. The slip tip does not enter the fluid pathway. In the study by Guy Cook it was shown to be 93% to 99% better than all other connectors studied. Again a poster at AVA presented by Sophie Harnage discussed a central line bundle that included the InVision Plus® Neutral® connector with outcome results of zero CRBSI for 15 months in a community hospital. Her work spoke to the issue of protecting both the extraluminal catheter track and the intraluminal fluid pathway.
Hi, Susan: I would first search the rest of this site; there are a number of helpful discussions about needleless connectors. There are multiple variables to consider when examining connectors - from priming volume/air space, moving parts, etc, and you need to consider the whole system as well (line, syringe, connector...).
You could also check out Marcia Ryder et.al.'s study on needleless connectors; she gave an excellent presentation at AVA this year and provided very helpful information about bacterial transfer rates through different types of connectors, and about different studies that have been done about them.
Best,
Mari Cordes, BS RN
Nurse Educator IV Therapy
Fletcher Allen Health Care
Mari Cordes, BS RNIII VA-BC
Vascular Access Department
University of Vermont Medical Center
will get you to her group's poster on bacterial transfer through needlefree connectors.
You can also purchase an audio copy of her talk at the AVA conference this year (sound's like you weren't there - if you were, you could view her presentation handouts on the AVA website).
Read ANY of Marcia Ryder's articles on biofilm.
(and my apologies for the formatting on this - doesn't work so well with Safari/Apple!)
Hope this helps,
Mari
Mari Cordes, BS RN
Nurse Educator IV Therapy
Fletcher Allen Health Care
Mari Cordes, BS RNIII VA-BC
Vascular Access Department
University of Vermont Medical Center
Mari Cordes, BS RNIII VA-BC
Vascular Access Department
University of Vermont Medical Center
Could you please share an address for this study done by Marcia Ryder?
Thanks,
Cat Johnson BA, RN, CRNI
(I just passed my exam last week!!!!!!!!!!)
Robbin George RN VA-BC
Mari Cordes, BS RNIII VA-BC
Vascular Access Department
University of Vermont Medical Center