The Role of IV Needleless Connectors and IV Complication Management and Prevention

Abstract

The most common complications associated with vascular access devices are catheter related bloodstream infections (CR-BSI), which occur in acute care patients every minute, and occlusions. This review will address major issues associated with patient care and research associated with vascular access and intravenous (IV) needleless connectors including descriptions of different types of connectors, care and maintenance issues such as septum disinfection and flushing, education of students and practitioners, a new framework for research and relevant questions for healthcare practitioners to ask during patient assessment. Two overall strategies to prevent CR-BSI’s and occlusions;                 1) prevent the active and passive migration of microorganisms into the fluid pathway and 2) prevent microorganism adhesion to the catheter surface will be discussed. The IV needleless connector, which is placed on the catheter hub is the gatekeeper to the intraluminal fluid pathway and its design directly impacts the success of strategies to prevent complications. Best practice requires that practitioners have specific knowledge of connector technology as well as patient factors for caring for vascular access devices.  There is a large gap in the scientific literature and in policies and procedures related to evidenced based decision making associated with care and maintenance of needleless intravenous connectors. Understanding IV needleless IV connectors is necessary to meld research and practice together for best patient practices, so the occurrences of CR-BSI’s and occlusions can be mitigated and eliminated.