An IV connector known as an intraluminal protection device (IPD) significantly outperformed two widely used negative-pressure IV connectors in research performed at Methodist Extended Care Hospital (MECH).
An IV connector is a small but crucial device that helps provide intravenous therapy to patients by connecting tubing to catheters. A substantially lower rate of central line-associated bloodstream infections (CLABSIs) was observed when the IPD was used instead of the negative-pressure devices.
The research featuring the hospital’s findings was reported in the Summer 2012 issue of the Journal of the Association for Vascular Access (JAVA). The author of the article is Debra Lynch, BSN, RN, NE-BC, the infection prevention lead at MECH.
“This study shows that if this IV connector is added to best nursing practices, it is possible to achieve major reductions in potentially deadly bloodstream infections,” says Lynch.
In the study, the observed CLABSI rate when the IPD (InVision-Plus® by RyMed Technologies) was used was 0.5/1,000 catheter days. That figure is far below the national average and a significant improvement over previous CLABSI rates for the hospital.
“We always put our patients first, which is why we’ve used the best technology available, and why we make sure that our clinicians follow the best evidence-based practices,” says Sandra Bailey-DeLeeuw, CEO of MECH. “This new research shows that our efforts to minimize infections are working.”
The study compared the IPD to two other kinds of IV needleless connectors that are commonly used in hospitals. Lynch found an infection rate that was 6 to 12 times higher with the negative-pressure IV connectors. These rates are well above national averages.
The much lower CLABSI rate with the IPD is particularly noteworthy when many long-term acute care (LTAC) patients have multiple co-morbidities which may increase their risk of infection.
As with other LTAC facilities, patients are usually admitted to MECH with central lines already in place. That means MECH has no control over significant CLABSI risk factors such as site selection, catheter selection, insertion protocol, and the catheter care and maintenance that occurred prior to the patient’s admission. Yet the IPD achieved an extremely low infection rate.
The research performed at MECH is consistent with previously published research. That research associates the IPD with lower infection rates and also has identified negative-pressure split septum and negative-pressure mechanical valves with higher CLABSI rates.
The national effort to minimize CLABSIs has important implications for hospitals from both a patient safety and financial standpoint.
According to the CDC, an estimated 250,000 CLABSIs occur each year in the U.S. The attributable mortality for the infections is 12 percent to 25 percent. CLABSIs also cost roughly $34,508 to $56,000 per episode to treat, the CDC reports. The Centers for Medicare and Medicaid Services (CMS) has stopped reimbursing hospitals for CLABSIs acquired in healthcare settings, so hospitals bear the cost for infections they are unable to prevent.
The major post-insertion cause of CLABSIs is from the entry of bacteria into the patient’s bloodstream through the IV connector’s intraluminal fluid pathway. The IPD has design features that are thought to protect against bacterial invasion, when properly cleaned prior to access.
These features prevent most blood residue from sticking to the connector’s intraluminal surface where it can become a precursor to biofilm and thus infection. These design elements also make the catheter easier to thoroughly disinfect and flush.