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nseals
Nexiva IV Catheters

 Has anyone had any experience with the Nexiva closed system IV catheters?  Our hospital is trying to switch over to these for better Infection Prevention compliance, but I am getting a lot of push-back from staff regarding how hard they are to start on patients, painful to patients, cannot free flow IV fluid quickly trough the attached J-loop, drag of needle when withdrawing after starting, etc.  I'm worried I made the wrong decision.  Any advice?

Nan Morris
Nexiva catheters

We've been using the Nexiva catheter for several years.  The nurses in the acute care areas and the Vascular Access Team preferred them to a Braun catheter we trialed and so we're keeping them, despite a somewhat higher cost. 

I do remember some people having some difficulty removing the needle when we first swiitched to these from our previous Intima catheters, but now we prefer them. If you pull the needle back very slightly prior to use, then return it to its original position, this helps (I double checked the instructions on its use to be sure this was acceptable, the link is here: http://www.bd.com/infusion/pdfs/ITS0003.pdf .  The attached loop, I think, is a bonus, no need to add a separate piece for access/clamping.

Nancy

jill nolte
Love them!

 It took me a bit to get the feel of Nexiva and yes withdrawing the needle was difficult.  Once I got the hang of it they became my favorite catheter.  I love them for several reasons.  A big one is there will always be a loop on the IV.  So often nurses place a needleless connector right on to the cannula without a loop, not possible with Nexiva!  Before my skills improved, IV starts were more like a blood letting and the Nexiva would have been nice to have had in those days.  My advice is to stay positive, keep encouraging them, and in time they will love the Nexiva.  You know why the switch was made, trust yourself.

 

I believe MD Anderson uses these catheters, maybe they have some tips for you???

Dincekol
nexiva

 We switched to Nexiva in the chemo clinic few years ago. Initially staff disliked the product because Nexiva requried slightly different insertion technique.  After 3 months, staff loved it. . It's cleaner - safer (minimal to none of blood exposure), and patients love it too. The only drawback, its more expensive - especially if you require multiple cannulations for a patient. Positioning can also a bit akward at times depending on the insertion site. 

sbmosher
nexiva catheters

We switched to them a few years ago. It was initially because the CT department was have problems with tubing blowing apart at the hub during power injection. As a member of the IV Team, I was happy with what we were using but once we got the hang of the Nexivas, we loved them. They give a quicker flash and thread easily as long as you break the seal by pulling back 1/8" and returning to original position. BD recommends this and it is important to do to be successful. The flat platform makes them secure nicely and prevents a lot of movement of the catheter. We use the Tegaderm that was designed to go with Nexiva catheters. Drawing blood on the initial insertion is so easy and there is no discard. No blood exposure to the inserter is huge and its just a matter of time before CDC and OSHA mandate it. We got lots of push back from the staff and frankly many of them acted like toddlers having tamper tantrums! Anesthesia still refuses to use them but then again they still prep with alcohol and slap silk tape over the insertion site!

Janine Pritchett
Nexiva catheters

We just looked at the different options for blood control catheters - and are going to trial the Insyte Autoguard Blood Control. Nexiva was one of the catheters that was reviewed, but wasn't chosen for a couple of reasons - cost, learning curve for staff nurses who have to start PIV's (not all of the hospitals in our system have IV teams), and they didn't have all of the sizes needed for our trauma patients.  We will be trialing the IAGBC soon with hopefully a good response.  Blood exposure was the main reason for looking at a different catheter.  We currently use the Insyte Autoguard, so changing to the BC felt like the best move with the least change for floor nursing staff.  While generally the IV teams don't have big issues with blood exposre now, it is an issue for non-IV team staff. 

Janine Pritchett, RN-BC, BSN, VA-BC
Clinical Educator - Vascular Access

sbmosher
Insyte autoguard

We also looked at these and I beleive that they do prevent the flow of blood until something is attached to them. If it is connection of IV tubing for an infusion, that's one thing but if you first connect a syringe for blood draw and then remove the syringe to connect tubing there will be blood flow.

Tom4Shield
Nice catheter - once learned.

Nexiva is a nice catheter. It takes a learning process and often will manifest ones poor IV starting skills much like a high performance car will manifest very quickly ones bad driving skills. Take the time to learn how to use it and it will serve you well. Now, once you have that expensive catheter in place you'll want to keep it there secured and covered. Take a look at the Sorbaview Shield. It's not just a dressing it's built-in securement and dressing to allow you not have unscheduled re-starts.  Good luck.

We're nurses, we have been trained to do technical and detailed skills even if it means learning new ones all over again.

Cheers,

t

 

Tom Burns, RN BSN

Clinical Nurse Edu

MarkCVL
Wound any ultrasound

Would any ultrasound PIV inserters like to see a 22ga/2in (or longer) Nexiva?...Just asking

[email protected]
Nexiva IV Catheters

We did this conversion a few years ago. Definitely feel your pain. Not a poor choice in catheters. You will discover if you get with these people and watch them.... they are doing something that is causing their problems. People get to holding the gray area in front of the needle while trying to retract and dispose of the sylet.... they pinch a little too hard and that can cause the drag. We made a point of bringing back the BD educators and having them interface with each person who had issues and/or we did that ourselves. I set up a separate mailbox for complaints about Nexiva and then could track and help troubleshoot people. I kept saying " you have had the same IV catheter forever and now... you need to retrain your muscle memory. For the next few days talk yourself mentally step by step through the stick no matter what else is going on. It will become second nature to adjust to the differences sooner that way"

Jose Delp RN BSN VA-BC

Adele deRosenroll
Nexiva IV Catheters, great choice!

 We did a conversion just over a year ago. There were some difficulties during the change. The insertion technique is different than the  catheters we used previously. You need to be sure the nurses are holding the device correctly on the white finger grips and that they are only advancing the catheter forward and not pulling the needle back at the same time. Most people say they are not doing this but when you observe their technique they are pulling back. I have found  nurses who are learning the skill for the first time have much more success with the nexiva catheters. I think the benefits of this catheter are worth the effort to learn the insertion technique.

good luck

Adele deRosenroll RN BN

Clinical Nurse Educator

Vascular Access 

Betsy Harmon
Nexiva catheters

We changed to the Nexiva catheter several years ago at my previous hospital. There was push back from several nurses until we looked at their technique. You basically have 2 different types of technique "Pushers" and "Pullers". The "Pushers" will be far more successful because they push the catheter into the vein, get the flashback and PUSH the catheter off the needle into the vein. The "Pullers" are the ones that get the needle into the vein and attempt to pull the needle back and then float the catheter into the vein, but since they pulled the needle from the vein the catheter won't go any further. After about 4 months and lots of training and hand holding with PIV boards on the floors for lots of practicing you probably would not be able to pry this catheter away from the nurses. The safety component of no blood, and immediate covering of the sharp when disengaged is fabulous and from the infection control standpoint you are not putting your dirty gloved finger just above your insertion site to hold pressure while you attempt to attach your extension set. You do not need a statlock or any other securement device. A tegaderm over the catheter & insertion site with a piece of tape where the extension set comes out from the tegaderm holds the catheter securely due to the large base with the wings. You also don't have to pad because of the soft base and the added bonus is that you have power injectable catheters. They are really nice.

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