Positive Pressure Valve on Peripheral IVs

Specialties Infusion

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Is anyone out there using a Positive Pressure Valve on all your Central Lines as well as your Peripheral Lines?

I heard from a nurse that a Positive Pressure Valve was not recommended for peripheral lines. I have not been able to find any documentation that states this. I would think a Positive Pressure Valve would decrease overall catheter occlusions.

Please let me know if you might have any insight on this.

shawnmed

We only use them on central lines and PICC lines due to the high cost. Our oncology unit is going to trial them on peripheral lines in patients who are very difficult starts to see if they can be helpful in decreasing the number of restarts in these patients. I don't think they're contraindicated for this use, but they are expensive.

Specializes in Inpatient Acute Rehab.

We use them only on Piccs and central lines due to the high cost.

We use them on everything.........And if you look at the different brands out there, they arent much different in cost...

We started with the BD Posiflow.....and found the the ultrasite by braun was cheaper and about the same price as the injection caps we were using prior. I think they were the baxter one's, with the white ring...Its been a few years ago.

If you are using a positive pressure valve on central lines and peripherals, have you seen any decrease in catheter occlusions? Are there any benefits to using it on all the lines?

We havent seen any increase.

I appreciate your comments, BobNurse.

Shawnmed

The valves are designed to eliminate the use of Heparin for flushing, which in turn decreases the incidence of heparin-induced thrombocytopenia. Since most facilities have eliminated the use of heparin for flushing peripheral lines and only use saline they aren't indicated (according to the manufacturers) for peripheral lines at this time. If a study could show that they decrease the incidence of repeated IV restarts on patients with "bad veins", that could help justify the increased cost. Often, facilities contract with a particular company for IV supplies, so shopping around may not be an option.

We've been using positive pressure valves on peripheral to central lines for about 5 years now. Like i said, we started with the posiflow by BD for the first 2 years, then switched to the Braun Ultrasite the last 3 years. We utilitze PICC lines (Bard Groshong) quite extensively and have not had any problems. I didnt realize there were problems and am now researching this.

We made the switch to the posiflow to better comply with the new needless act that came out back then.....But no problems so far........

I would like to know what problems are occurring at a national level with the positive pressure valves........If anyone can let me know.

We've been using positive pressure valves on peripheral to central lines for about 5 years now. Like i said, we started with the posiflow by BD for the first 2 years, then switched to the Braun Ultrasite the last 3 years. We utilitze PICC lines (Bard Groshong) quite extensively and have not had any problems. I didnt realize there were problems and am now researching this.

We made the switch to the posiflow to better comply with the new needless act that came out back then.....But no problems so far........

I would like to know what problems are occurring at a national level with the positive pressure valves........If anyone can let me know.

One specific problem associated with positive pressure values tends to be problems with increase of catheter related blood stream infections (CR-BSI). Stick down and leakage has also been reported. bobnurse I can e-mail you a couple of articles if you are interested. Just let me know

Donna

Thanks, Bobnurse & Donna. Your insight is surely appreciated. I've downloaded a few articles online that addresses the CR-BSI. They problem is not only with positive pressure connectors. Its needleless systems altogether. A couple of reasons why...

1. Not all nurses are swabbing the connector before they access the valve.

2. Most of the valves can't be swabbed thoroughly because of the design of the valve. For instance, with the Ultrasite there is no way you can totally swab that valve due to the bumps & ridges on top of the valve. Bacteria & germs reside here that can't be removed since swabbing is an action of friction. You have to have a totally flush swabbing surface in order to be effective. Otherwise you don't have an aseptic device.

3. Some of the valves have huge poppet stickdown issues when clamped. This is a potential problem with the Posiflows.

Let me know if you would like me to forward you a few published studies regarding this. Thanks again for sharing your experiences.

I would love to read these articles. Thank you all........

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