Controlling peripheral intravenous catheter failure by needleless connector design: A pilot randomised controlled trial

Article


Marsh, Nicole, Larsen, Emily, O'Brien, Catherine, Peach, Hannah, Keogh, Samantha, Davies, Karen, Mihala, Gabor, Hewer, Barbara, Booker, Catriona, McCarthy, Alexandra L., Flynn, Julie and Rickard, Claire M.. 2023. "Controlling peripheral intravenous catheter failure by needleless connector design: A pilot randomised controlled trial." Journal of Clinical Nursing. 32 (21-22), pp. 7909-7919. https://doi.org/10.1111/jocn.16852
Article Title

Controlling peripheral intravenous catheter failure by needleless connector design: A pilot randomised controlled trial

ERA Journal ID14104
Article CategoryArticle
AuthorsMarsh, Nicole, Larsen, Emily, O'Brien, Catherine, Peach, Hannah, Keogh, Samantha, Davies, Karen, Mihala, Gabor, Hewer, Barbara, Booker, Catriona, McCarthy, Alexandra L., Flynn, Julie and Rickard, Claire M.
Journal TitleJournal of Clinical Nursing
Journal Citation32 (21-22), pp. 7909-7919
Number of Pages11
Year2023
PublisherJohn Wiley & Sons
Place of PublicationUnited Kingdom
ISSN0962-1067
1365-2702
Digital Object Identifier (DOI)https://doi.org/10.1111/jocn.16852
Web Address (URL)https://onlinelibrary.wiley.com/doi/10.1111/jocn.16852
Abstract

Aim: To test the feasibility of a study protocol that compared the efficacy of neutral- and negative-pressure needleless connectors (NCs).

Design: A single-centre, parallel-group, pilot randomised control trial.

Methods: Our study compared neutral-(intervention) and negative-pressure (control) NCs among adult patients in an Australian hospital. The primary feasibility outcome was measured against predetermined criteria (e.g. eligibility, attrition). The primary efficacy outcome was all-cause peripheral intravenous catheter failure, analysed as time-to-event data.

Results: In total, 201 (100 control; 101 intervention) participants were enrolled between March 2020 and September 2020. All feasibility criteria were met except eligibility, which was lower (78%) than the 90% criterion. All-cause peripheral intravenous catheter failure was significantly higher in the intervention group (39%) compared to control (19%).

Conclusion: With minor modifications to participant screening for eligibility, this randomised control trial is feasible for a large multicentre randomised control trial. The neutral NC was associated with an increased risk of peripheral intravenous catheter failure.

Implications for the profession and/or patient care: There are several NC designs available, often identified by their mechanism of pressure (positive, negative and neutral). However, NCs can contribute to peripheral intravenous catheter failure. This is the first randomised controlled trial to compare neutral and negative NC designs. Negative pressure NCs had lower PIVC failure compared to neutral NCs, however the results might not be generalisable to other brands or treatment settings. Further high-quality research is needed to explore NC design.

Keywordsadult nursing; clinical; clinical trial; evidence-based nursing; health services research; nursing practice; nursing research; randomised controlled trials
ANZSRC Field of Research 2020420599. Nursing not elsewhere classified
Byline AffiliationsRoyal Brisbane and Women’s Hospital, Australia
Griffith University
University of Queensland
Queensland University of Technology
School of Nursing and Midwifery
Mater Research Institute, Australia
Metro North Health, Australia
Permalink -

https://research.usq.edu.au/item/z38q9/controlling-peripheral-intravenous-catheter-failure-by-needleless-connector-design-a-pilot-randomised-controlled-trial

  • 42
    total views
  • 25
    total downloads
  • 2
    views this month
  • 0
    downloads this month

Export as

Related outputs

Novel Peripheral Intravenous Catheter Securement for Children and Catheter Failure Reduction
Charters, Charters, Foster, Kelly, Lawton, Benjamin, Lee, Leonard, Byrnes, Joshua, Mihala, Gabor, Cassidy, Corey, Schults, Jessica, Kleidon, Tricia M., Mccaffery, Ruth, Van, Kristy, Funk, Vanessa and Ullman, Amanda. 2024. "Novel Peripheral Intravenous Catheter Securement for Children and Catheter Failure Reduction." JAMA Pediatrics. 178 (5), pp. 437-445. https://doi.org/10.1001/jamapediatrics.2024.0167
Embedding planetary health in nursing education: exploring the barriers and enablers to implementing changes in undergraduate Bachelor of Nursing curriculum
Martin, Sophia, Richards, Catelyn, Keogh, Samantha and Ward, Aletha. 2024. "Embedding planetary health in nursing education: exploring the barriers and enablers to implementing changes in undergraduate Bachelor of Nursing curriculum." Teaching and Learning in Nursing. 19 (2), pp. e261-e268. https://doi.org/10.1016/j.teln.2023.11.008
Safety and efficacy of midline catheters versus peripheral intravenous catheters: A pilot randomized controlled trial
Marsh, Nicole, Larsen, Emily N., O'Brien, Catherine, Ware, Robert S., Kleidon, Tricia M., Groom, Peter, Hewer, Barbara, Alexandrou, Evan, Flynn, Julie, Woollett, Kaylene and Rickard, Claire M.. 2023. "Safety and efficacy of midline catheters versus peripheral intravenous catheters: A pilot randomized controlled trial." International Journal of Nursing Practice. 29 (2), pp. 1-11. https://doi.org/10.1111/ijn.13110
Comparing compliance with commencement and use of two partograph designs for women in active labour: A randomised controlled trial
Lee, Nigel, Flynn, Julie, Gao, Yu and Kildea, Sue. 2023. "Comparing compliance with commencement and use of two partograph designs for women in active labour: A randomised controlled trial." Women and Birth. 36 (1), pp. e17-e24. https://doi.org/10.1016/j.wombi.2022.04.004
Reimagining the role of nursing education in emissions reduction
Ward, Aletha, Heart, Diane, Richards, Catelyn, Bayliss, Luke T., Holmes, Mark, Keogh, Samantha and Best, Odette. 2022. "Reimagining the role of nursing education in emissions reduction." Teaching and Learning in Nursing. 17 (4), pp. 410-416. https://doi.org/10.1016/j.teln.2022.02.003
Evaluating methods for the use and decontamination of needleless connectors: A qualitative inquiry
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
On a quest to prevent harm and safeguard paediatric venous catheters – A randomized control trial protocol
Charters, Brooke, Foster, Paed Acute, Lawton, Benjamin, Cassidy, Corey, Byrnes, Joshua, Mihala, Gabor, Schults, Jessica, Kleidon, Tricia, Mccaffery, Ruth, Van, Kristy and Ullman, Amanda. 2022. "On a quest to prevent harm and safeguard paediatric venous catheters – A randomized control trial protocol." Vascular Access. 16 (3), pp. 18-26.
Response to the Letter to the Editor regarding “Methods for microbial needleless connector decontamination: A systematic review and meta-analysis”
Flynn, Julie M., Larsen, Emily N., Keogh, Samantha, Ullman, Amanda J. and Rickard, Claire M.. 2019. "Response to the Letter to the Editor regarding “Methods for microbial needleless connector decontamination: A systematic review and meta-analysis”." American Journal of Infection Control. 47 (12), pp. 1521-1522. https://doi.org/10.1016/j.ajic.2019.07.002
Securement methods for peripheral venous catheters to prevent failure: a randomised controlled pilot trial
Marsh, Nicole, Webster, Joan, Flynn, Julie, Mihala, Gabor, Hewer, Barbara, Fraser, John and Rickard, Claire. 2015. "Securement methods for peripheral venous catheters to prevent failure: a randomised controlled pilot trial." The Journal of Vascular Access. 16 (3), pp. 237-244. https://doi.org/10.5301/jva.5000348
Needleless connector decontamination: To use, or not to use, chlorhexidine?
Flynn, Julie, Slater, Karen, Cooke, Marie and Rickard, Claire M.. 2018. "Needleless connector decontamination: To use, or not to use, chlorhexidine?" American Journal of Infection Control. 46 (8), pp. 959-960. https://doi.org/10.1016/j.ajic.2018.03.003
An observational study of nurses’ intravenous flush and medication practice in the clinical setting
Keogh, Samantha, Shelverton, Caroline, Flynn, Julie, Davies, Karen, Marsh, Nicole and Rickard, Claire M.. 2017. "An observational study of nurses’ intravenous flush and medication practice in the clinical setting." Vascular Access. 3 (1), pp. 1-18. https://doi.org/10.3316/informit.629496319613481
Evaluating methods for effective decontamination of central venous access devices needleless connectors in adult hospital patients: A pilot randomised control trial protocol
Flynn, Julie M., Keogh, Samantha, Zhang, Li and Rickard, Claire M.. 2017. "Evaluating methods for effective decontamination of central venous access devices needleless connectors in adult hospital patients: A pilot randomised control trial protocol." Vascular Access. 3 (2), pp. 1-18. https://doi.org/10.3316/informit.632663924727375
The MIDLINE trial – managing intravenous devices among patients with limited vascular access or prolonged therapy: a pilot randomised control trial protocol
Marsh, Nicole, Larsen, Emily, Flynn, Julie, O’Brien, Catherine, Kleidon, Tricia, Groom, Peter, Hewer, Barbara and Rickard, Claire M.. 2020. "The MIDLINE trial – managing intravenous devices among patients with limited vascular access or prolonged therapy: a pilot randomised control trial protocol." Vascular Access. 6 (1), pp. 20-24. https://doi.org/10.33235/va.6.1.20-24
Maternal positioning with flexed thighs to correct foetal occipito-posterior position in labour: A systematic review and meta-analysis
Lee, Nigel, Munro, Victoria, Oliver, Kirra and Flynn, Julie. 2021. "Maternal positioning with flexed thighs to correct foetal occipito-posterior position in labour: A systematic review and meta-analysis." Midwifery. 99. https://doi.org/10.1016/j.midw.2021.103008
Disinfection of Needleless Connector Hubs: Clinical Evidence Systematic Review
Moureau, Nancy L. and Flynn, Julie. 2015. "Disinfection of Needleless Connector Hubs: Clinical Evidence Systematic Review." Nursing Research and Practice. 2015, pp. 1-20. https://doi.org/10.1155/2015/796762
Nursing and midwifery practice for maintenance of vascular access device patency. A cross-sectional survey
Keogh, Samantha, Flynn, Julie, Marsh, Nicole, Higgins, Niall, Davies, Karen and Rickard, Claire M.. 2015. "Nursing and midwifery practice for maintenance of vascular access device patency. A cross-sectional survey." International Journal of Nursing Studies. 52 (11), pp. 1678-1685. https://doi.org/10.1016/j.ijnurstu.2015.07.001
Alcohol Caps or Alcohol Swabs With and Without Chlorhexidine: An In Vitro Study of 648 Episodes of Intravenous Device Needleless Connector Decontamination
Flynn, Julie M., Rickard, Claire M., Keogh, Samantha and Zhang, Li. 2017. "Alcohol Caps or Alcohol Swabs With and Without Chlorhexidine: An In Vitro Study of 648 Episodes of Intravenous Device Needleless Connector Decontamination." Infection Control and Hospital Epidemiology. 38 (5), pp. 617-619. https://doi.org/10.1017/ice.2016.330
Infection risks associated with peripheral vascular catheters
Zhang, Li, Cao, Siyu, Marsh, Nicole, Ray-Barruel, Gillian, Flynn, Julie, Larsen, Emily and Rickard, Claire M.. 2016. "Infection risks associated with peripheral vascular catheters." Journal of Infection Prevention. 17 (5), pp. 207-213. https://doi.org/10.1177/1757177416655472
Methods for microbial needleless connector decontamination: A systematic review and meta-analysis
Flynn, Julie M., Larsen, Emily N., Keogh, Samantha, Ullman, Amanda J. and Rickard, Claire M.. 2019. "Methods for microbial needleless connector decontamination: A systematic review and meta-analysis." American Journal of Infection Control. 47 (8), pp. 956-962. https://doi.org/10.1016/j.ajic.2019.01.002
Varied flushing frequency and volume to prevent peripheral intravenous catheter failure: a pilot, factorial randomised controlled trial in adult medical-surgical hospital patients
Keogh, Samantha, Flynn, Julie, Marsh, Nicole, Mihala, Gabor, Davies, Karen and Rickard, Claire. 2016. "Varied flushing frequency and volume to prevent peripheral intravenous catheter failure: a pilot, factorial randomised controlled trial in adult medical-surgical hospital patients." Trials. 17 (1), pp. 1-10. https://doi.org/10.1186/s13063-016-1470-6
Central venous Access device SeCurement And Dressing Effectiveness for peripherally inserted central catheters in adult acute hospital patients (CASCADE): a pilot randomised controlled trial
Chan, Raymond J., Northfield, Sarah, Larsen, Emily, Mihala, Gabor, Ullman, Amanda, Hancock, Peter, Marsh, Nicole, Gavin, Nicole, Wyld, David, Allworth, Anthony, Russell, Emily, Choudhury, Md Abu, Flynn, Julie and Rickard, Claire M.. 2017. "Central venous Access device SeCurement And Dressing Effectiveness for peripherally inserted central catheters in adult acute hospital patients (CASCADE): a pilot randomised controlled trial." Trials. 18 (1), pp. 1-13. https://doi.org/10.1186/s13063-017-2207-x
Flushing of peripheral intravenous catheters: A pilot, factorial, randomised controlled trial of high versus low frequency and volume in paediatrics
Kleidon, Tricia M., Keogh, Samantha, Flynn, Julie, Schults, Jessica, Mihala, Gabor and Rickard, Claire M.. 2020. "Flushing of peripheral intravenous catheters: A pilot, factorial, randomised controlled trial of high versus low frequency and volume in paediatrics." Journal of Paediatrics and Child Health. 56 (1), pp. 22-29. https://doi.org/10.1111/jpc.14482
Implementation and evaluation of short peripheral intravenous catheter flushing guidelines: a stepped wedge cluster randomised trial
Keogh, Samantha, Shelverton, Caroline, Flynn, Julie, Mihala, Gabor, Mathew, Saira, Davies, Karen M., Marsh, Nicole and Rickard, Claire M.. 2020. "Implementation and evaluation of short peripheral intravenous catheter flushing guidelines: a stepped wedge cluster randomised trial." BMC Medical. 18 (1), pp. 1-11. https://doi.org/10.1186/s12916-020-01728-1
Needleless connector decontamination for prevention of central venous access device infection: A pilot randomized controlled trial
Rickard, Claire M., Flynn, Julie, Larsen, Emily, Mihala, Gabor, Playford, E Geoffrey, Shaw, Joanie, Keogh, Samantha, Ullman, Amanda, Zhang, Li, Gavin, Nicole, Kleidon, Tricia, Chopra, Vineet, McCarthy, Alexandra L., Rocha, Patricia Kuerten and Marsh, Nicole. 2021. "Needleless connector decontamination for prevention of central venous access device infection: A pilot randomized controlled trial." American Journal of Infection Control. 49 (2), pp. 269-273. https://doi.org/10.1016/j.ajic.2020.07.026
Clinically-indicated replacement versus routine replacement of peripheral venous catheters [Review]
Webster, J., Osborne, S., Rickard, C. M. and Hall, J.. 2010. "Clinically-indicated replacement versus routine replacement of peripheral venous catheters [Review]." Cochrane Database of Systematic Reviews. 2010 (3), pp. 1-41.
Clinically-indicated replacement versus routine replacement of peripheral venous catheters [Review]
Webster, J., Osborne, S., Rickard, C. M. and New, K.. 2013. "Clinically-indicated replacement versus routine replacement of peripheral venous catheters [Review]." Cochrane Database of Systematic Reviews. 2013 (4), pp. 1-42.
Clinically-indicated replacement versus routine replacement of peripheral venous catheters [Review]
Webster, J., Osborne, S., Rickard, C. and New, K.. 2015. "Clinically-indicated replacement versus routine replacement of peripheral venous catheters [Review]." Cochrane Database of Systematic Reviews. 2015 (8), pp. 1-45. https://doi.org/10.1002/14651858.CD007798.pub4
Prevention of Occlusion of cEnTral lInes for Children with cancer: An implementation study
Ullman, Amanda J., Condon, Paula, Edwards, Rachel, Gibson, Victoria, Takashima, Mari, Schults, Jessica, Dean, Anna, Cattanach, Paula, Nicholls, Wayne, Osborne, Sonya, Rickard, Claire M., Cooke, Marie and Kleidon, Tricia. 2020. "Prevention of Occlusion of cEnTral lInes for Children with cancer: An implementation study." Journal of Paediatrics and Child Health. 56 (12), pp. 1875-1884. https://doi.org/10.1111/jpc.15067
Clinically-indicated replacement versus routine replacement of peripheral venous catheters
Webster, Joan, Osborne, Sonya, Rickard, Claire M and Marsh, Nicole. 2019. "Clinically-indicated replacement versus routine replacement of peripheral venous catheters." Cochrane Database of Systematic Reviews. 2019 (1), pp. i-55. https://doi.org/10.1002/14651858.CD007798.pub5
Sterile v aseptic non-touch technique for needle-less connector care on central venous access devices in a bone marrow transplant population: A comparative study
Flynn, Julie M., Keogh, Samantha J. and Gavin, Nicole C.. 2015. "Sterile v aseptic non-touch technique for needle-less connector care on central venous access devices in a bone marrow transplant population: A comparative study." European Journal of Oncology Nursing (EJON). 19 (6), pp. 694-700. https://doi.org/10.1016/j.ejon.2015.05.003
Clinically-indicated replacement versus routine replacement of peripheral venous catheters [Review]
Webster, Joan, Osborne, Sonya, Rickard, Clare M. and New, Karen. 2013. "Clinically-indicated replacement versus routine replacement of peripheral venous catheters [Review]." Cochrane Database of Systematic Reviews. https://doi.org/10.1002/14651858.CD007798.pub3