Needleless Connectors Practice Recommendations

According to the Infusion Therapy Standards of Practice a Luer-locking needleless connector is used to connect syringes and/or administration sets to a vascular access device (VAD) hub or other injection site to eliminate use of needles and reduce needlestick injuries.

Here are some key practice recommendations for needleless connectors (NCs):

1. Use a luer-lock mechanism to ensure a secure connection when attaching the NC to a vascular access device (VAD) or access site.
2. Disinfect NCs before accessing them each time.
3. Only access NCs with sterile devices.
4. Change needleless connectors in the following situations:
   • When they are removed for any reason
   • If blood or debris are found inside them
   • Before drawing blood samples for culturing from the VAD
   • If contamination occurs
   • According to facility policies and manufacturer directions
5. Use NCs with the following safety features:
   • A smooth, solid access surface that can be effectively disinfected
   • A visible fluid path for verifying flushing
   • A straight fluid path
   • Minimal internal complexity
   • No blood reflux
   • Ability to flush with saline solution alone
6. Consider using passive disinfecting caps containing isopropyl alcohol on NCs, as they have been shown to reduce intraluminal contamination and central line-associated bloodstream infection rates.
7. Ensure disinfecting supplies for NCs are readily available at the bedside to facilitate staff compliance with proper disinfection practices.
8. Apply principles of Aseptic Non Touch Technique (ANTT) when handling NCs, treating them as key-parts that must be protected from contamination.

Instructions for Connecting Needle-Free Valves to Catheter Luer Connectors:

• Ensure Proper Handling: Hold the Synergy CT PICC Luer connector firmly in your preferred hand. Seat the provided needle-free valve into the catheter Luer connector.
• Gentle Twist: Carefully rotate the needle-free valve until a slight or moderate resistance is felt. CAUTION: Avoid excessive tightening, as it may result in damage to the catheter Luer connector and needle-free valve
• Confirm Connection: After securely placing the needle-free valve into the catheter Luer connector, proceed to adhere to hospital protocols and follow the instructions for use (IFUs) to complete the catheter preparation for infusion.

Adhering to these practice recommendations for needleless connectors can significantly enhance patient safety by reducing the risk of needlestick injuries, minimizing thrombotic VAD lumen occlusions, and lowering infection rates. Regular training and adherence to established protocols are crucial for healthcare providers to ensure the best outcomes in clinical settings.

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References:

Nickel, B. et al., (2024, January/ February) Infusion Therapy Standards of Practice 9th edition. Journal of Infusion Nursing. https://www.ins1.org/publications/infusion-therapy-standards-of-practice/