Is there evidence for recommending needleless closed catheter access systems in guidelines? A systematic review of randomized controlled trials

Niël‐Weise, Barbara S; Daha, Thea; Broek, P.J. van den

doi:10.1016/j.jhin.2005.10.005

Cited by 25 publications

(12 citation statements)

References 16 publications

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“…Estudo holandês (14) de revisão sobre essa temática, encontrado na literatura, também reconheceu problemas de condução das pesquisas analisadas. Além disso, a busca de evidências sobre práticas assistenciais específicas, como na área de controle de infecção, exige, além da necessidade de atender aos critérios de elaboração dos ensaios clínicos controlados e randomizados, também o controle dos diversos fatores de risco de infecção, capazes de interferir nos resultados, além daquele sob intervenção (15) .…”

Section: Resultsunclassified

Impacto dos conectores sem agulhas na infecção da corrente sanguínea: revisão sistemática

Mendonça

Lacerda

2010

Acta paul. enferm.

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RESUMOEsta revisão sistemática buscou evidenciar o impacto do uso de conectores sem agulhas para sistema fechado de infusão na ocorrência de infecção da corrente sanguínea relacionada ao cateter venoso central. A amostra constitui-se de 14 estudos, os quais investigaram somente conectores sem agulhas. A infecção da corrente sanguínea relacionada ao cateter venoso central foi o desfecho de nove estudos. Seis apresentaram diferenças a favor do conector valvulado; quatro a favor do conector puncionável com cânula; um a favor do conector puncionável com agulha; um a favor do conector valvulado com pressão positiva e dois a favor do dispositivo usado antes da troca. A heterogeneidade dos estudos não permitiu a realização de metanálise. Descritores: Literatura de revisão como assunto; Infecções relacionadas a cateter; Infecção hospitalar ABSTRACT Esta revisión sistemática buscó evidenciar el impacto del uso de conectores sin agujas para sistemas cerrados de infusión en el caso de ocurrir una infección en la corriente sanguínea relacionada al catéter venoso central. La muestra fue constituida de 14 estudios, los cuales investigaron solamente conectores sin agujas. La infección de la corriente sanguínea relacionada al catéter venoso central fue el resultado de nueve estudios. Seis presentaron diferencias a favor del conector de válvula; cuatro a favor del conector para punción con cánula; uno a favor del conector para punción con aguja; uno a favor do conector de válvula con presión positiva y dos a favor del dispositivo usado antes del cambio. La heterogeneidad de los estudios no permitió la realización de una meta-análisis. Keywords: Review literature as topic; Catheter-related infections; Cross infection RESUMENThis systematic review was intended to evaluate the impact of using needleless connectors in closed infusion systems in the event of a bloodstream infection related to central venous catheter. The sample consisted of 14 studies, which investigated only needleless connectors. The bloodstream infection related to central venous catheter was the result of nine studies. Six produced evidence in favor of the valve connector, four in favor of the cannula connector for puncturing, one in favor of needle connector, one in favor of positive pressure valve connector, and two in favor of the device used before the change. The heterogeneity of the studies did not allow the realization of a metaanalysis. Descriptores: Literatura de revisión como asunto; Infecciones relacionadas con catéteres; Infección hospitalaria

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Section: Resultsunclassified

Impacto dos conectores sem agulhas na infecção da corrente sanguínea: revisão sistemática

Mendonça

Lacerda

2010

Acta paul. enferm.

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“…Because catheters provide an open conduit into the vasculature, a NC is attached, via luer threaded connection, to the integrated hub end of the catheter establishing a closed system. Studies reflecting benefits of closed systems with NC have trended toward demonstration of protection for catheter and hub colonization [4,119]. In a prospective controlled study by Rosenthal and Maki and multicenter prospective cohort by Rangel-Frausto et al, open systems compared to closed systems resulted in major reductions in catheter related infections [120].…”

Section: Why Disinfect?mentioning

confidence: 99%

Disinfection of Needleless Connector Hubs: Clinical Evidence Systematic Review

Moureau¹

2015

Journal of the Association for Vascular Access

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Background. Needleless connectors (NC) are used on virtually all intravascular devices, providing an easy access point for infusion connection. Colonization of NC is considered the cause of 50% of postinsertion catheter-related infections. Breaks in aseptic technique, from failure to disinfect, result in contamination and subsequent biofilm formation within NC and catheters increasing the potential for infection of central and peripheral catheters. Methods. This systematic review evaluated 140 studies and 34 abstracts on NC disinfection practices, the impact of hub contamination on infection, and measures of education and compliance. Results. The greatest risk for contamination of the catheter after insertion is the NC with 33-45% contaminated, and compliance with disinfection as low as 10%. The optimal technique or disinfection time has not been identified, although scrubbing with 70% alcohol for 5-60 seconds is recommended. Studies have reported statistically significant results in infection reduction when passive alcohol disinfection caps are used (48-86% reduction). Clinical Implications. It is critical for healthcare facilities and clinicians to take responsibility for compliance with basic principles of asepsis compliance, to involve frontline staff in strategies, to facilitate education that promotes understanding of the consequences of failure, and to comply with the standard of care for hub disinfection.

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“…Needleless, open, and closed hub systems have not been demonstrated to change CR-BSI rates [47 ]. There is no role for prophylactic antibiotics in preventing CR-BSI.…”

Section: Miscellaneous Prevention Strategiesmentioning

confidence: 99%