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Needleless connector nursing care – Current practices, knowledge, and attitudes: An Australian perspective

  • Karen Slater
    Correspondence
    Corresponding author. Division of Medicine, Princess Alexandra Hospital, 199 Ipswich Rd, Brisbane 4102, Australia.
    Affiliations
    Princess Alexandra Hospital, Brisbane, 4102, Australia

    School of Nursing and Midwifery, Griffith University, Brisbane, 4111, Australia

    Alliance for Vascular Access Teaching & Research (AVATAR) Group, Menzies Health Institute Queensland, Griffith University, Brisbane, 4111, Australia
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  • Marie Cooke
    Affiliations
    School of Nursing and Midwifery, Griffith University, Brisbane, 4111, Australia

    Alliance for Vascular Access Teaching & Research (AVATAR) Group, Menzies Health Institute Queensland, Griffith University, Brisbane, 4111, Australia
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  • Michael Whitby
    Affiliations
    Greenslopes Clinical School, University of Queensland, Brisbane, 4120, Australia
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  • Claire M. Rickard
    Affiliations
    Princess Alexandra Hospital, Brisbane, 4102, Australia

    School of Nursing and Midwifery, Griffith University, Brisbane, 4111, Australia

    Alliance for Vascular Access Teaching & Research (AVATAR) Group, Menzies Health Institute Queensland, Griffith University, Brisbane, 4111, Australia

    School of Nursing, Midwifery and Social Work, University of Queensland, Herston and Metro North Hospital and Health Service, Brisbane, 4006, Australia
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      Highlights

      • Survey of nurses' knowledge and practice of NC care.
      • 89% of nurses clean NCs each time before access.
      • 25% of nurses correctly recognized negative pressure NCs, 79% chose the correct clamping sequence.
      • 44% of nurses correctly recognized positive pressure NCs, 34% chose the correct clamping sequence.
      • Nurses reported their behaviour is most influenced by local senior nurses.

      Abstract

      Background

      Inappropriate needleless connector (NC) care is associated with device failure from catheter occlusion and patient blood stream infections (BSIs). This can be attributed to a lack of knowledge of connector designs and flushing, clamping, and syringe disconnection techniques. This study aimed to assess nurses’ practice, knowledge, attitudes, and key influencers on appropriate care of NCs in an Australian facility and compare these with studies undertaken in the United States in 2011.

      Methods

      A cross-sectional online survey was sent via email with a SurveyMonkey® link to all nurses working in clinical areas (total population sampling approach; approximately 1500 nurses), at an Australian hospital, in 2018. The survey was anonymous and open for 6 weeks. Analysis was with R software.

      Results

      Response rate was approximately 19% (n = 283). Most (89%) of nurses stated that they clean NCs before each access. Only 25% correctly recognised the negative pressure NC, and 79% correctly identified the correct clamping and disconnection sequence. Positive pressure displacement devices were correctly identified by 44% of respondents, with 34% identifying the correct clamping and disconnecting technique. Nurses reported their behaviour was most influenced by local senior nurses.

      Conclusions

      There remains a significant gap in nurses' knowledge of NC device types, as well as the correct clamping and syringe disconnection for both negative and positive displacement NCs. This survey reaffirms that senior nurses are the key influencers of nurses’ adherence to best practice guidelines.

      Keywords

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