INS states needleless connectors should be changed no more frequently than 96 hours; when used within a continous infusion system the needleless connector is changed when the primary administration set is changed. Lets say a patient has 2 or 3 ports with a continous infusion going through one port but nothing through the others. I would think that the ports that do not have the continuous infusion going would have the needleless connectors changed at the same time the port with the continous infusion has its administration set changed ( to keep things simple).... but what if the continous administration set becomes contaminated a day after all the needleless connectors are changed and you have to hang a new administration set along with a new needleless connector( i'm sure you wouldn't change the others also- too much manipulation) but how in the world do you keep track of when to change the others???
Some facilities change the needleless connectors with the dressing change q 7 days for intermittant infusions- is this acceptable? Are changing the needleless connectors part of the dressing change?
I hope my questions aren't too confusing and thank you in advance!
I would eliminate the use of all needleless connectors inside a system used for continuous infusion. See INS Standard on Needlelless Connectors - no evidence that they are beneficial for continuous and may increase infection risk. And as you identified they add complexity to patient care. "No more frequently than" means you can extend their use longer than 96 hours, so changing those on an intermittent lumen with the dressing change would be acceptable. 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
Thank you so much!
Our policy states based on 2011CDC to change the microclave connector daily for intermittent tubing.
INS standard says changing on a more frequent time interval adds no benefit and has been shown to increase the risk of CLABSI.
Based on the INS should we change our policy to state no more frequenly than 96 hours?
dee morrisond
Actually, the 2011 CDC Guidelines state to "change the needleless connector at least as frequently as the administration set. There is no benefit to changing these more frequently than every 72 hours." So there is some misinterpretation of this CDC statement by your facility. The statement applied to continuous infusion administration sets and not those used for intermittent infusions. CDC also states the length of use and frequency of change for intermittent sets is an unresolved issue. This CDC guideline is very old now and the 2016 INS Standards are consistent with the CDC statements that there is no benefit for very frequent change of the connectors. I think daily change is adding to hub manipulation and may be increasing your risk of contamiantion. I would change my policy to change the needleless connector for intermittent use every 96 hours. This should be the same frequency as changing your continuous infusion sets. If you use a needleless connector inside a continuous infusion system, you would always change the connector at the same time as the set change. 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