There are six items related to the needleless endovascular catheter system mentioned in the 2017 CDC / HICPAC Intravascular Catheter Related Infection Prevention Guide, including the frequency of replacement of needleless connectors, matching of catheter system components, Use and selection of connectors.

1.The birth and change of needleless infusion connector

Needle-free infusion connectors were originally created to prevent needle stick injuries. From 1992, the United States Office of Occupational Safety and Health Administration (OSHA) recommended that all medical devices adopt appropriate "engineering design" to help medical personnel avoid bloodborne Exposure. By the 2001 Acupuncture Safety and Prevention Act, the use of a needle-free connection system became a mandatory requirement, and the incidence of acupuncture injuries by medical staff was significantly reduced.

However, as some clinical studies have found that the significant increase in bloodstream infection rates may be related to the widespread use of mechanical valve needleless connectors. As a result, the US Food and Drug Administration (FDA) declared in 2010 that: Needle-free mechanical valve connector manufacturers are required to conduct a post-market clinical re-experiment to provide relevant risk assessments to "self-certify innocence".

According to statistics from the United States CDC, about 20% of hospital-acquired infections in the ICU are bloodstream infections, of which nearly 87% are related to the central venous catheter (CVC) [2].

The latest "Concept of Experts on Best Practices in Prevention and Control of Catheter-related Infection" states that 30% of catheter-related infections are due to contamination of catheter joints. Among the three ways that microbes cause catheter infections, these include infections caused by microbes that contaminate catheter joints and the lumen, causing bacteria to multiply in the lumen.

2.An in vitro study of the difference between microbial invasion rates of needleless connectors

The needle-free connector was inoculated with Staphylococcus aureus, and two different disinfection schemes were compared for 5 seconds and 15 seconds, and then a 7-day clinical practice simulation (blood collection, bolus and continuous infusion) was performed. The results show that the risk of infection may be related to the structure of the needleless connector itself, and the microbial count may be related to the shape of the connection site, which affects the disinfection effect of the connector;

However, there are no significant differences between the median number of colonies (CFU) recovered by some needleless connectors after the 5 and 15 second disinfection protocol. The results showed that prolonged disinfection time may still not be enough to remove some microbial contamination of needleless connectors, which may be related to the design of needleless connectors.

A 2015 systematic review of needleless connector disinfection practices [2], which included 140 studies and 34 abstracts. It also proves that the disinfection of needleless joints depends on the roughness of the joint and the location and number of grooves or gaps present.

If a needleless connector is used to eliminate needle stick injuries, a good connector is much more than that. Although it is not clear that certain types of needle-free infusion joints have advantages in preventing CRBSI and thrombotic obstruction , infusion joints with smooth surfaces are easier to sterilize, and transparent infusion joints are easy to visualize the flushing effect.

3.Simple design interprets the sensory control philosophy of the joint

Connector housing transparent

The path is completely transparent and visible, which is convenient for observation and evaluation management, and helps to achieve a thorough flushing and avoid complications caused by incomplete flushing.

Simple internal structure

The flow path of the connector is straight, which facilitates flushing and reduces the possibility of medicinal fluid and blood residue in the cavity.

Smooth and tight surface

Can be fully disinfected to prevent invasion of bacteria

A good connector is like a guard against bacteria, reducing the incidence of CRBSI and truly guarding the patient.

A good joint has a simple structure, a straight channel can be seen, and nursing quality management should not be so complicated.

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