IV Catheter Care and Maintenance Minimizes Catheter-Related Blood Stream Infection

Abstract

The elimination of catheter-related bloodstream infections (CR-BSI) requires meticulous intravenous (IV) catheter care. There are three different types of needlefree connectors and one intraluminal protection device that require different care regimens, including the correct usage of disinfectants, flushing techniques, and clamping sequences. The nurse must be able to identify which connector is in use and select the appropriate care. This care must be followed not only in the inpatient unit by the bedside nurse but also in areas that are providing diagnostic procedures such as the cardiac cath lab. Since bacterial adhesion to the intraluminal catheter wall is the primary building block of a CR-BSI, which may not present until days after initial inoculation, preventing intraluminal fluid pathway contamination is paramount with every access. In addition, many institutions have more than one type of connector available. This complicates the provision of consistent safe care. Split septum, negative mechanical valves, positive pressure mechanical valves, and intraluminal protection devices have specific care and maintenance requirements. This article discusses the different connector types, why each requires special care, how intraluminal fluid pathway contamination can lead to CR-BSI, and how simple nursing care and maintenance practices of connector septum swabbing and catheter flushing by the cardiac cath nurse can help prevent this serious complication.