Does anyone know of any research that shows the ultrasite valve to be a poor product in regards to infection control? I have seen studies using the safe-site and am looking for this named product specifically. It's pretty clear when looking at the cap that even the best nurse cannot clean all the nooks and crannies.
Our hospital has a huge contract with Braun and this cap is on all tubing. To request changing vendors will require supporting data.
Is there anyone that has changed manufacturers because of their cap design? What data did you use to convince the powers to be to change? What are the options?
Kathy Kokotis
Bard Access Systems
Google Dr. Jarvis for any info on caps and infection
Kathy
Kathy Kokotis
Bard Access Systems
The best review of all connectors is a poster done by Guy Cook Bactrin Inc. It was shown at the SHEA conference in Baltimore 2007. You can view it at www.rymedtech.com. While there has been some discussion of lumping devices into groups, the reason that positive pressure devices have probems is tey have numerous areas of deadspace. I understand from Guy Cook that bacteria know when a wall is near as the flow slows (much like eddies in a river stream). The dead space is filled with the first aspiration of blood and can not be flushed clean (why it is call dead space). We know that fibrin is the building block for the bacteria. All positive pressure devices have tortuous intraluminal fluid pathways. The design was developed to reduce occlusion. At the time no one was really studying infection rates. When Jarvis and his fellow infectious disease docs got together at SHEA in 2004, the group realized that something must be going on. Both Jarvis and Maki have stated numerous times in various open platforms that they believe that positive pressure devices should not be used.
Denise Macklin
Also - Marcia Ryder's work. Search this forum and you'll find multiple references.
Mari Cordes, BS RN
Mari Cordes, BS RNIII VA-BC
Vascular Access Department
University of Vermont Medical Center
Not every positive pressure device has deadspace!
Some are very hard to clean, no matter is negative or positive, everything stays and falls with bedside nursing.
The question is, why do we use positive pressure technique since late 80.....because there is a benefit related to our lines.
I use positive pressure device and my infection rate is by 0.2 for my Picc lines.
Check with your infection control nurse and see what works for your hospital and for your nurses best, evaluate, trial and go from there.
Andre Schotte
RCRMC