No published studies assess the knowledge of staff nurses regarding intravenous connectors, yet connectors remain a primary cause of infection and mortality. Anonymous survey (N = 100) in acute hospitals revealed 78% of nurses were uninformed about different connector types and their different care and 43% could not name two complications of connectors. No significant relationship was found between education (r = 0.121, p < 0.05) or nursing specialty (r =-0.059, p < 0.05) and identifying types of connectors. Sixty-four per cent were involved in 5—6 hours of intravenous therapy and maintenance per 12-hour shift, hence connector care is significant. Education about connectors has implications for nursing associated with catheter-related bloodstream infections, occlusion and thrombosis. The Centers for Disease Control includes catheter-related bloodstream infections as a worldwide priority. This study identified a significant need for further nursing education and research regarding the types, maintenance and care of intravenous connectors.
Bassetti S., Hu J., D’Agostino Jr, RB, and Sherertz RJ ( 2001) Prolonged antimicrobial activity of a catheter containing chlorhexidine-silver sulfadiazine extends protection against catheter infections in vivo. Antimicrob Agents Chemother45: 1535-1538.
2.
Baxter Healthcare (2007) Sustainability and safety. Available at: sustainability.baxter.com/documents/sustainability_report_2007.pdf (accessed 8 July 2009).
3.
Caillouet, B. ( 2008) The evolution of the injection cap-combining staff safety and patient safety . Presented at the 22nd Annual AVA Conference, Savannah, GA, 11 September.
4.
Casella L., Jarvis E. ( 2007) Save a patient’s line with positive pressure. Acute & Critical Care Special Interest Group Newsletter. Pittsburgh, PA: Oncology Nursing Society, 3-4.
5.
Casey AL, Elliott TSJ ( 2007) The usability and acceptability of a needleless connector system. Br J Nurs16: 267-271.
6.
Casey AL, Worthington T., Lambert PA, Quinn D., Faroqui MH, and Elliott TS ( 2003) A randomized, prospective clinical trial to assess the potential infection risk associated with the PosiFlow needleless connector . J Hosp Infect54: 288-293.
7.
Dougherty L. ( 2000) Central venous access devices. Nurs Stand14(43): 45-50.
8.
Dougherty L., Watson J. ( 2008) Vascular access devices: insertion and management . In: Dougherty L, Lister S (eds) The Royal Marsden Hospital Manual of Clinical Nursing Procedures, 7th edn. Oxford: Wiley-Blackwell, 855-918.
9.
Field K., McFarlane C., Cheng AC, et al. (2007) Incidence of catheter-related bloodstream infection among patients with a needleless, mechanical valve-based intravenous connector in a Australian hematology-oncology unit. Infect Control Hosp Epidemiol28: 610-613.
10.
Gallieni M., Pittiruti M., and Biffi R. ( 2008) Vascular access in oncology patients. CA Cancer J Clin58: 323-346.
11.
Institute for Healthcare Improvement (2007 ) Central Line Bundle Compliance. Available at: http://www.ihi.org/IHI/Topics/CriticalCare/IntensiveCare/Measures/CentralLineBundleComplianceRate.htm (accessed 21 October 2008 ).
12.
Jarvis W., Sheretz R., Perl T., Bradley K., and Giannetta E. ( 2005) Increased central venous catheter-associated bloodstream infection rates temporarily associated with changing from a split-septum to a luer-access mechanical valve needleless device: a nationwide outbreak?Am J Infect Control33(5): e14-e15.
13.
Karchmer TB, Cook E., Palavecino E., Ohl C., and Sherertz R. ( 2005) Needleless valve ports may be associated with a high rate of catheter-related bloodstream infection. Program and abstracts of the 15th Annual Scientific Meeting of the Society for Healthcare Epidemiology of America, 9-12 April, Los Angeles, USA. Abstract 307.
14.
Macklin D., Chernecky CC ( 2004) Real World Nursing Survival Guide: IV Therapy. Saunders: St. Louis, MO, USA.
15.
Maragakis LL, Bradley KL, Song X., et al. (2006) Increased catheter-related bloodstream infection rates after introduction of a new mechanical valve intravenous accessport . Infect Control Hosp Epidemiol27(1): 67-68.
16.
Marschall J., Mermel LA, Classen D., et al. (2008) Strategies to prevent central line-associated bloodstream infections in acute care hospitals. Infect Control Hosp Epidemiol29 (Suppl 1): S22-S30.
17.
Menyhay SZ, Maki DG ( 2006) Disinfection of needleless catheter connectors and access ports with alcohol may not prevent microbial entry: the promise of a novel antiseptic-barrier cap. Infect Control Hosp Epidemiol27: 23-27.
18.
National Audit Office (2005) A Safe Place for Patients. Learning to Improve Patient Safety. London: National Audit Office.
19.
O’Grady NP, Alexander M., Dellinger EP, et al. (2002) Centers for Disease Control and Preventions (CDC), Hospital Infection Control Practices Advisory Committee. MMWR Recomm Rep2002, 1(RR-10), 1-26.
20.
O’Hanlon S., Glen R., and Hazler B. ( 2008) Delivering intravenous therapy in the community setting . Nurs Stand22(31): 44-48.
21.
Orem DE ( 1995) Nursing: Concepts of Practice, 5th edn. New York: McGraw-Hill.
22.
Rello J., Ochogavia A., Sabanes E., et al. (2000) Evaluation of outcome of intravenous catheter-related infections in critically ill patients. Am J Respir Crit Care162: 1027-1030.
23.
Rosenthal K. ( 2006) Do needleless connectors increase bloodstream infection risk? Nurs Manage37(4): 78-80.
24.
Rummel MA, Donnelly PJ, and Fortenbaugh CC ( 2001) Clinical evaluation of a positive pressure device to prevent central venous catheter occlusion: results of a pilot study. Clin J Oncol Nurs5: 261-265.
25.
Rupp ME, Sholtz LA, Jourdan DR, et al. (2007) Outbreak of bloodstream infection temporally associated with the use of an intravascular needleless valve. Clin Infect Dis44: 1408-1414.
26.
Scales K.(2009) Intravenous therapy: the legal and professional aspects of practice . Nurs Stand23(33): 51-57.
27.
Schilling S., Doellman D., Hutchinson N., and Jacobs BR ( 2006) The impact of needleless connector device design on central venous catheter occlusion in children: prospective, controlled trial. J Parenteral Enteral Nutrition30: 85-90.
28.
Simmons D. ( 2006) Safe systems, safe patients: common connectors pose a threat to safe practice. Texas Board of Nursing Bull37: 6-7.
29.
Soufir L., Timsit JF, Mahe C., Carlet J., Regnier B., and Chevret S. ( 1999) Attributable morbidity and mortality of catheter-related septicemia in critically ill patients: a matched, risk-adjusted, cohort study . Infect Control Hosp Epidemiol20: 396-401.
30.
SPSS for Windows (2001) Chicago, IL: SPSS Inc. Weinstein SM (2007) Plumer’s Principles and Practice of Intravenous Therapy, 8th edn. Philadelphia, PA: Lippincott Williams & Wilkins.
31.
Yébenes JC, Vidaur L., Serra-Prat M., et al. (2004) Prevention of catheter-related bloodstream infection in critically ill patients using a disinfectable, needle-free connector: A randomized controlled trial. Am J Infect Control32: 291-295.
