Controlling peripheral intravenous catheter failure by needleless connector design: A pilot randomised controlled trial.

J Clin Nurs

School of Nursing and Midwifery, Alliance for Vascular Access Teaching and Research (AVATAR), School of Pharmacy and Medical Science, School of Medicine and Dentistry, Griffith University, Nathan, Queensland, Australia.

Published: November 2023

AI Article Synopsis

  • The study aimed to evaluate the effectiveness of neutral versus negative-pressure needleless connectors in preventing peripheral intravenous catheter failure among adult patients in an Australian hospital.
  • The research was a pilot randomized control trial involving 201 participants, where neutral connectors resulted in a higher catheter failure rate (39%) compared to negative connectors (19%).
  • While the trial met most feasibility criteria, it indicated that adjustments to participant eligibility screening were necessary, and highlighted the need for further research on needleless connector designs to better understand their impact on patient care.

Article Abstract

Aim: To test the feasibility of a study protocol that compared the efficacy of neutral- and negative-pressure needleless connectors (NCs).

Design: A single-centre, parallel-group, pilot randomised control trial.

Methods: Our study compared neutral-(intervention) and negative-pressure (control) NCs among adult patients in an Australian hospital. The primary feasibility outcome was measured against predetermined criteria (e.g. eligibility, attrition). The primary efficacy outcome was all-cause peripheral intravenous catheter failure, analysed as time-to-event data.

Results: In total, 201 (100 control; 101 intervention) participants were enrolled between March 2020 and September 2020. All feasibility criteria were met except eligibility, which was lower (78%) than the 90% criterion. All-cause peripheral intravenous catheter failure was significantly higher in the intervention group (39%) compared to control (19%).

Conclusion: With minor modifications to participant screening for eligibility, this randomised control trial is feasible for a large multicentre randomised control trial. The neutral NC was associated with an increased risk of peripheral intravenous catheter failure.

Implications For The Profession And/or Patient Care: There are several NC designs available, often identified by their mechanism of pressure (positive, negative and neutral). However, NCs can contribute to peripheral intravenous catheter failure. This is the first randomised controlled trial to compare neutral and negative NC designs. Negative pressure NCs had lower PIVC failure compared to neutral NCs, however the results might not be generalisable to other brands or treatment settings. Further high-quality research is needed to explore NC design.

Reporting Method: Study methods and results reported in adherence to the CONSORT Statement.

Patient Or Public Contribution: No patient or public contribution.

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http://dx.doi.org/10.1111/jocn.16852DOI Listing

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