Needleless connectors

[AWellborn]

Please share what type of needleless connectors your facilities are using on PICCS. I am studying for Vascular Access Certification and the study guide covers Negative/Positive/Neutral Displacement valves.

My question is regarding Bard's PowerPicc with valves in hubs and no clamps. Do these concepts apply if the catheter already has a valve? My facility is currently using a positive displacement valve with this product however we have no way to clamp the catheter to follow the suggested sequence of flushing.

I have read about neutral and zero displacement products but they have mixed reviews.

Also, concerned about infection control and are antimicrobial/silver coated connectors better?

Thank you so much...my facility has done PICC lines for years, but there is great room to grow and improve!!!!

[Asystole RN]

I would say neutral displacement is becoming the far more popular type of needle-less access device. The Bard SOLO catheter (the one with the valve you are referring to) is expensive. If you are spending the money on that catheter then the valve is not as important. Personally, I would rather have a PowerPICC or something less expensive and have a nicer NAD. There is a great study in the last Journal of Infusion Nurses that was about the physical features of the NADs and the ability to clean them. There was a substantial difference.

I would personally not take "reviews" too seriously and would conduct my own evaluation. Look up several NADs and invite the companies in to talk about them and evaluate them on a unit or two and see for yourself.

[IVRUS, BSN, RN]

If the IV catheter has a clamp on it, or has an extension set attached to the hub of the IV catheter then clamping can be done, but please remember that if you are using a positive displacement needleless connector, the clamping is done AFTER syringe removal.

If the IV catheter is valved, there won't be a clamp on the catheter itself, so flush, and remove your syringe. That's it. With the negative and neutral caps, most clinicians usually do positive pressure flushing: Flush with the recommended solution and then while pushing the last 2/10th in, clamp simultaneously.