Abstract and Introduction
Introduction
A years-long national effort to minimize catheter-related bloodstream infections (CR-BSIs) has produced only modest results. The Centers for Disease Control and Prevention (CDC) compared data from January through June 2009 to data from 2006 through 2008, and found these infections had decreased only 18%. The statistics are troubling, especially given the current intense focus on preventing hospital-acquired infections.
Why do CR-BSIs still kill patients every year? Some experts believe I.V. connector design is a contributing factor. The Food and Drug Administration (FDA) requires all manufacturers of positive-displacement (PD) I.V. connectors to conduct postmarketing surveillance studies to assess whether they could be linked to a higher CR-BSI rate than other types and to assess factors that may contribute to the possible increased risk.
FDA has taken this step because it has received information on possible safety problems linked to PD needless connectors, including three reports of deaths. But despite mounting evidence against these connectors, they're still used widely. William Jarvis, MD, an internationally recognized infection control expert, notes that studies also link negative-displacement (ND) connectors with increased CR-BSIs.
As primary caregivers, nurses are responsible for the care and maintenance of central venous catheters. This article describes the various I.V. connector designs available and explains why some designs are more effective than others in preventing infections.