For a continuous infusion, yes, definitely! This is the preferred method for all continuous infusions, both peripheral and central, in my opinion. The needleless connector adds risk of infection. The 2014 SHEA compendium now states the use of NC for all continuous infusions is an unknown practice. I teach connect hub to hub on all continuous infusions but I know others disagree with me. We have no evidence to support tht this or is not a safe practice. Lynn
To answer your question I think it is acceptable practice. I also think this is one of those topics where reality does not necessarily jibe with theory. In theory a continuous infusion is just that, continuous. In reality many patients(and nurses for that matter) disconnect continuous infusions for a multitude of things. Bathing, gown changes, showers, going to the bathroom etc. etc. I would want to assess my patients understanding of the hazards of a central line port with no IV connector. For most patients I would disagree with Lynn in that the risks of infection or more serious consequences(air embolism, bleeding if inadvertently disconnected) outweigh the theoretical benefits of a continuous infusion. I think this is a caregiver and patient knowledge dependent question.
Needleless connectors can become inadvertently disconnected just as easily as a tubing hub. Part of the problem is in the lingo...I know a lot of nurses that call needleless connectors "caps." Reality should always jive with theory. It's just a matter of educating staff to use equipment the way it was invented and intended to be used. Now where did I just put that Penrose tourniquet?
Keith W. Gilchrist, MSN, RN, PHN, OCN, CRNI, VA-BC
Oncology Nurse Navigator, David Grant Medical Center
Travis AFB, CA
My point is that all of those disconnections are totally unnecessary and should not be allowed. Gowns are made with shoulder snaps. The container and tubing can be run through a sleeve. This never happened in my clinical world before the wide spread use of needleless connectors. And those connectors were and are designed for only intermittent use. Their presence is a risk but one we accept for intermittent infusion. But we don't have to or need to accept it for continuous infusions. All that disconnecting is a serious hazard for contamination. INS standards repeat the need for the least amount of manipulation of the catheter hub and entire IV administration set. Lynn
For a continuous infusion, yes, definitely! This is the preferred method for all continuous infusions, both peripheral and central, in my opinion. The needleless connector adds risk of infection. The 2014 SHEA compendium now states the use of NC for all continuous infusions is an unknown practice. I teach connect hub to hub on all continuous infusions but I know others disagree with me. We have no evidence to support tht this or is not a safe practice. Lynn
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
To answer your question I think it is acceptable practice. I also think this is one of those topics where reality does not necessarily jibe with theory. In theory a continuous infusion is just that, continuous. In reality many patients(and nurses for that matter) disconnect continuous infusions for a multitude of things. Bathing, gown changes, showers, going to the bathroom etc. etc. I would want to assess my patients understanding of the hazards of a central line port with no IV connector. For most patients I would disagree with Lynn in that the risks of infection or more serious consequences(air embolism, bleeding if inadvertently disconnected) outweigh the theoretical benefits of a continuous infusion. I think this is a caregiver and patient knowledge dependent question.
MHC
Needleless connectors can become inadvertently disconnected just as easily as a tubing hub. Part of the problem is in the lingo...I know a lot of nurses that call needleless connectors "caps." Reality should always jive with theory. It's just a matter of educating staff to use equipment the way it was invented and intended to be used. Now where did I just put that Penrose tourniquet?
Keith W. Gilchrist, MSN, RN, PHN, OCN, CRNI, VA-BC
Oncology Nurse Navigator, David Grant Medical Center
Travis AFB, CA
Keith W. Gilchrist, MSN, RN, PHN, OCN, CRNI, VA-BC
Oncology Nurse Navigator, David Grant Medical Center
Travis AFB, CA
My point is that all of those disconnections are totally unnecessary and should not be allowed. Gowns are made with shoulder snaps. The container and tubing can be run through a sleeve. This never happened in my clinical world before the wide spread use of needleless connectors. And those connectors were and are designed for only intermittent use. Their presence is a risk but one we accept for intermittent infusion. But we don't have to or need to accept it for continuous infusions. All that disconnecting is a serious hazard for contamination. INS standards repeat the need for the least amount of manipulation of the catheter hub and entire IV administration set. Lynn
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