CLABSI Rates Decrease When Using a Zero Fluid Displacement Connector

The ability to decrease CLABSI has seen some improvement but more is necessary to prevent negative patient outcomes. One area that has not been researched is the actual technology or connector product and its effect on bloodstream infections.

Using the Healthcare and Technology Synergy (HATS) model, the purpose of this multicenter study by Chernecky, et al. (2013) was to compare central line-associated bloodstream infection (CLABSI) rates associated with the use of intravenous (IV) positive or negative (including mechanical valve and split septum devices) pressure needleless connectors to a zero fluid displacement needleless connector.

The quasi-experimental study was conducted over 140 months, five states, six specialty settings (three ICUs, and one each of medical ICU, surgical ICU and LTAC) comparing CLABSI rates associated with positive (6,649 catheter-days) or negative (17,810 catheter-days) IV needleless connectors. There were a total of 24,459 pre-zero fluid displacement catheter-days over 70 months compared to 25,621 total post zero displacement connector catheter-days over 70 months. Paired t-tests were used to examine differences between catheter-days and CLABSI rates before and after zero fluid displacement connector adoption. Statistical significance was assessed using an alpha level of 0.05.

The number of catheter days was similar both before and after zero fluid displacement connector adoption. There was a statistically significant higher CLABSI rate when either negative (p = 0.039) or positive (p = 0.0158) pressure mechanical IV connectors were used. Overall, a decrease in CLA-BSIs per 1000 catheter days was found after changing from negative, or positive IV connectors to the zero fluid displacement connector (p = 0.005).

Chernecky, et al. (2013) documented a statistically significant decrease in CLABSI rates when either a negative or positive IV needleless connectors were changed to a zero fluid displacement connector in multiple acute settings. The researchers say the data reveals that IV needleless connector design impacts CLABSI rates and product is a significant variable in the HATS model for comparative effectiveness.

Disclosures: C. Chernecky: None declared; D. Macklin: shareholder of RyMed Technologies Inc, consultant for RyMed Technologies Inc.; W. Jarvis: None declared; T. Joshua: None declared.

Reference: Chernecky C, Macklin D, Jarvis JR and Joshua T.  Poster presentation P001 at 2nd International Conference on Prevention and Infection Control (ICPIC 2013): Comparison of central line-associated bloodstream infection rates when changing to a zero fluid displacement intravenous needleless connector in acute care. Antimicrobial Resistance and Infection Control 2013, 2(Suppl 1):P1 doi:10.1186/2047-2994-2-S1-P1.