Evaluating methods for the use and decontamination of needleless connectors: A qualitative inquiry

Article


Larsen, Emily N., August, Deanne, Keogh, Samantha, Flynn, Julie, Ullman, Amanda J., Marsh, Nicole, Cooke, Marie, McCarthy, Alexandra L. and Rickard, Claire M.. 2022. "Evaluating methods for the use and decontamination of needleless connectors: A qualitative inquiry." Infection, Disease and Health. 27 (4), pp. 175-183. https://doi.org/10.1016/j.idh.2022.04.002
Article Title

Evaluating methods for the use and decontamination of needleless connectors: A qualitative inquiry

ERA Journal ID15767
Article CategoryArticle
AuthorsLarsen, Emily N. (Author), August, Deanne (Author), Keogh, Samantha (Author), Flynn, Julie (Author), Ullman, Amanda J. (Author), Marsh, Nicole (Author), Cooke, Marie (Author), McCarthy, Alexandra L. (Author) and Rickard, Claire M. (Author)
Journal TitleInfection, Disease and Health
Journal Citation27 (4), pp. 175-183
Number of Pages9
Year2022
PublisherElsevier
Place of PublicationNetherlands
ISSN1835-5617
1835-5625
2468-0451
Digital Object Identifier (DOI)https://doi.org/10.1016/j.idh.2022.04.002
Web Address (URL)https://www.sciencedirect.com/science/article/pii/S2468045122000207
Abstract

Background
Needleless connectors (NCs) are essential devices designed to provide safe, needle-free connection between venous access devices, syringes and infusions. There is a variety of designs, and associated decontamination products and practices; the resulting confusion can cause detrimental patient outcomes. This study aimed to explore nurses’ attitudes, techniques, and practices around the use and decontamination of NCs in clinical practice.

Methods
Qualitative inquiry was conducted with seven focus groups of 4–6 participants each in the cancer and surgical units of a large tertiary hospital in Australia between January and March 2019. Participants comprised nurses who had taken part in a recent clinical trial of NC decontamination. Focus group sessions were recorded, transcribed and synthesised using content analysis.

Results
Seven focus groups were conducted (total, N = 30 participants), lasting 16–20 min. Six major themes were identified surrounding needleless connector use and decontamination: ‘safety and utility’; ‘terminology and technological understanding’; ‘clinical practice determinants’; ‘decontamination procedures and influencers’; ‘education and culture’; and ‘research and innovation’.

Conclusion
The participants articulated positive attitudes towards needleless connector use for needle-stick and infection prevention, however rationales for care and maintenance practices demonstrated limited understanding of guidelines (e.g., disinfection time) and specific NC function (e.g., positive, negative pressure). The findings indicated the need for targeted, standardised needleless connector education, to enhance staff confidence, improve consistency of care and ensure patient safety.

KeywordsNeedleless connectors, Vascular access devices, Decontamination
ANZSRC Field of Research 2020420501. Acute care
420599. Nursing not elsewhere classified
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Byline AffiliationsGriffith University
Department of Health, Queensland
School of Nursing and Midwifery
University of Queensland
Institution of OriginUniversity of Southern Queensland
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