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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
Implementation of a novel aseptic insertion device for peripheral venous catheters: safety, performance, and nurse
Tamara Ruiz-Merlo1, Ana Irene Sánchez Morgado2, Patricia Brañas3
1Unit of Infectious Diseases, Hospital Universitario '12 de Octubre', Instituto de Investigación Sanitaria Hospital '12 de Octubre' (imas12), Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain.
Background:
Peripheral venous catheters (PVCs) are widely used invasive devices in hospitalised patients, but their insertion carries risks such as phlebitis, extravasation, and catheter-related bloodstream infections (CRBSIs). Current World Health Organization (WHO) guidelines recommend non-sterile gloves during PVC insertion, which conflicts with aseptic technique principles.
Aim:
To evaluate a patented device that was developed to prevent direct contact between non-sterile gloves and the catheter hub.
Methods:
We conducted a single-centre, non-comparative proof-of-concept study to assess the safety and feasibility of the device in routine clinical practice within an inpatient unit with an established PVC care bundle. Eighty-eight adult patients requiring PVCs for >48 h were included prospectively. Trained nurses inserted 116 PVCs using the device, with daily monitoring of complications and aseptic culture of catheter tips. Nurse satisfaction was surveyed.
Findings:
Most catheters (78.4%) were successfully inserted at the first attempt. Complication rates were as follows: phlebitis (1.7 episodes/100 catheter-days), extravasation (2.6/100 catheter-days) and pericatheter leakage (3.2/100 catheter-days). Of 73 cultured PVC tips, 95.9% were sterile and three showed skin flora growth without clinical phlebitis. No CRBSI cases were documented. Nurse satisfaction averaged 3.57/5, with 62.3% expressing satisfaction.
Conclusion:
The use of this innovative device, in conjunction with an established evidence-based care bundle, was associated with low complication and contamination rates and no cases of CRBSIs. These findings support the device's potential utility in promoting aseptic technique during PVC insertion without disrupting routine clinical workflows. Nurse satisfaction was moderate, as expected with the introduction of a new tool that modifies long-standing clinical routines.
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