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A Protocol to Set Up Needle-Free Connector with Positive Displacement on Central Venous Catheter in Intensive Care Unit
Published on: July 13, 2019
The relationship between intravenous infusate colonisation and fluid container hang time
Claire M Rickard1, Boun Vannapraseuth, Matthew R McGrail
1Research Centre for Clinical and Community Practice Innovation, Griffith University, Nathan, Qld, Australia. c.rickard@griffith.edu.au
Journal of Clinical Nursing
|October 14, 2009
Summary
Microbial colonization in intravenous fluids is very low, even after extended use, suggesting current practices effectively maintain sterility. Routine fluid changes may be unnecessary, warranting further research into optimal replacement protocols.
Area of Science:
- Infectious Diseases
- Microbiology
- Healthcare Epidemiology
Background:
- Catheter-related bloodstream infections (CRBSIs) are serious complications of intravascular devices.
- Colonized intravenous fluids pose a potential source of infection, yet incidence rates are poorly documented.
- The effectiveness of routine intravenous fluid replacement as an infection control measure remains uncertain.
Purpose of the Study:
- To assess microbial colonization levels in intravenous fluids after 24 hours of use in an acute care setting.
- To determine if routine, time-based replacement of infusate bags is necessary.
- To evaluate the risk of infusate-related bloodstream infections (IRBSIs).
Main Methods:
- A cross-sectional study was conducted over 18 months in a teaching hospital.
- 264 infusate specimens from crystalloid fluids used for ≥24 hours were cultured.
- Microbiological culture, sensitivity testing, and IRBSI rates were recorded; unopened solutions served as controls.
Main Results:
- The infusate colonization rate was 0.4% (0.09 per 1000 infusion hours), with only coagulase-negative Staphylococcus identified.
- Infusions had been used for 24-185 hours (1-8 days).
- No significant difference in duration of use was found between colonized and sterile specimens, and no IRBSIs occurred.
Conclusions:
- The incidence of intravenous fluid colonization and the risk of related bloodstream infections are low, even after prolonged use.
- Current practices appear effective in maintaining the sterility of intravenous fluids.
- Routine 24-hourly replacement of intravenous fluids may be unnecessary; further research is needed.
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