Hi! We are reviewing the 2021 INS Standard for possible improvements in our IV procedures. The Standard states to limit add-on devices. Does that include the needleless connector on the patient's line? Is the recommendation for continuous infusion lines to directly connect the distal hub of the IV tubing to the open hub of the patient's line? I have not seen that in decades, but it sounds like that may be the recommendation. That, and I believe I have seen that discussion a few years back on this website. Thank you!
The decision to remove the needleless connector from the infusion system of a continuous set is a decision your facility must make. As the SOP states, use of NC in this manner is unknown. There were never intended to be used this way. They were intended to prevent needle stick injuries and blood exposure when connecting syringes and sets to together for the safe delivery of intermittent meds. IMO, use of the NC in a continuous infusion system encourages bad practice because it allows for the nurse to frequently disconnect the infusion for any reason - ambulation, toileting, etc. This frequent disconnection adds risk for contamination and infection. The infusion ssytem should have the least number of connections and be manipulated the fewest number of times.
But remember if your nurses are now disconnecting for any reason, they must stop that practice. Without the NC in the system, the line is left open and air emboli is the risk. Truly for a continuous infusion, the set should only be disconnected from the catheter when it is time to change that set.
Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Office Phone 770-358-7861
Thank you for the clarification, Lynn.