{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T05:35:45Z","timestamp":1767159345126,"version":"build-2238731810"},"reference-count":26,"publisher":"Cambridge University Press (CUP)","issue":"6","license":[{"start":{"date-parts":[[2015,1,2]],"date-time":"2015-01-02T00:00:00Z","timestamp":1420156800000},"content-version":"unspecified","delay-in-days":6059,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[1998,6]]},"abstract":"Abstract<\/jats:title>\n \n \n OBJECTIVE:<\/jats:bold>\n <\/jats:title>\n To assess the effect on staff- and patient-related complications of a needleless intermittent intravenous access system with a reflux valve for peripheral infusions.<\/jats:p>\n <\/jats:sec>\n \n \n DESIGN:<\/jats:bold>\n <\/jats:title>\n A 6-month cross-over clinical trial (phase I, 13 weeks; phase II, 12 weeks) of a needleless intermittent intravenous access system (NL; study device) compared to a conventional heparin-lock system (CHL, control device) was performed during 1991 on 16 medical and surgical units. A random selection of patients was assessed for local intravenous-site complications; all patients were assessed for the development of nosocomial bacteremia and device-related complications. Staff were assessed for percutaneous injuries and participated in completion of product evaluations. A cost analysis of the study compared to the control device was performed.<\/jats:p>\n <\/jats:sec>\n \n \n SETTING:<\/jats:bold>\n <\/jats:title>\n A 1,100-bed, teaching, referral medical center.<\/jats:p>\n <\/jats:sec>\n \n \n PATIENTS AND STAFF PARTICIPANTS:<\/jats:bold>\n <\/jats:title>\n 594 patients during 602 patient admissions, comprising a random sample of all patients with a study or control device inserted within a previous 24-hour period on study and control units, were assessed for local complications. The 16 units included adult inpatient general medicine, surgical, and subspecialty units. Pediatrics, obstetrics-gynecology, and intensive-care units were excluded. All patients on study and control units were assessed for development of nosocomial bacteremia and device-related complications. All staff who utilized, manipulated, or may have been exposed to sharps on study and control units were assessed for percutaneous injuries. Nursing staff completed product evaluations.<\/jats:p>\n <\/jats:sec>\n \n \n INTERVENTION:<\/jats:bold>\n <\/jats:title>\n The study device, a needleless intermittent intravenous access system with a reflux valve, was compared to the control device, a conventional heparin lock, for peripheral infusions.<\/jats:p>\n <\/jats:sec>\n \n \n RESULTS:<\/jats:bold>\n <\/jats:title>\n \n During the study, 35 percutaneous injuries were reported. Eight injuries were CHL-related; no NL-related injuries were reported (\n P<\/jats:italic>\n =.007). An evaluation of 602 patient admissions, 1,134 intermittent access devices, and 2,268 observed indwelling device days demonstrated more pain at the insertion site for CHL than NL; however, no differences in objective signs of phlebitis were noted. Of 773 episodes of positive blood cultures on study and control units, 6 (0.8%) were device-related (assessed by blinded investigator), with no difference between NL and CHL. Complications, including difficulty with infusion (\n P<\/jats:italic>\n <.001) and disconnection of intravenous tubing from device (\n P<\/jats:italic>\n <.001), were reported more frequently with CHL than with NL. Of nursing staff responding to a product evaluation survey, 95.2% preferred the study over control device. The projected annual incremental cost to our institution for hospitalwide implementation of NL for intermittent access for peripheral infusions was estimated at $82,845, or $230 per 1,000 patient days.\n <\/jats:p>\n <\/jats:sec>\n \n \n CONCLUSIONS:<\/jats:bold>\n <\/jats:title>\n A needleless intermittent intravenous access system with a reflux valve for peripheral infusions is effective in reducing percutaneous injuries to staff and is not associated with an increase in either insertion-site complications or nosocomial bacteremia. Institutions should consider these data, available institutional resources, and institution-specific data regarding the frequency and risk of intermittent access-device-related injuries and other types of sharps injuries in their staff when selecting the above or other safety devices.<\/jats:p>\n <\/jats:sec>","DOI":"10.1086\/647839","type":"journal-article","created":{"date-parts":[[2009,9,9]],"date-time":"2009-09-09T15:52:29Z","timestamp":1252511549000},"page":"401-406","source":"Crossref","is-referenced-by-count":56,"title":["Study of a Needleless Intermittent Intravenous-Access System for Peripheral Infusions: Analysis of Staff, Patient, and Institutional Outcomes"],"prefix":"10.1017","volume":"19","author":[{"given":"Meryl H.","family":"Mendelson","sequence":"first","affiliation":[{"name":"the Mount Sinai Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Louise J.","family":"Short","sequence":"additional","affiliation":[{"name":"the Mount Sinai Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clyde B.","family":"Schechter","sequence":"additional","affiliation":[{"name":"the Mount Sinai Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Burt R.","family":"Meyers","sequence":"additional","affiliation":[{"name":"the Mount Sinai Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Margarita","family":"Rodriguez","sequence":"additional","affiliation":[{"name":"the Mount Sinai Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandra","family":"Cohen","sequence":"additional","affiliation":[{"name":"the Mount Sinai Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Lozada","sequence":"additional","affiliation":[{"name":"Mount Sinai School of Medicine of the City University of New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marvalyn","family":"DeCambre","sequence":"additional","affiliation":[{"name":"Mount Sinai School of Medicine of the City University of New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shalom Z.","family":"Hirschman","sequence":"additional","affiliation":[{"name":"the Mount Sinai Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2015,1,2]]},"reference":[{"key":"S0195941700087828_bib010","volume-title":"Proceedings of 31st Interscience Conference on Antimicrobial Agents and Chemotherapy","author":"Short","year":"1991"},{"key":"S0195941700087828_bib007","doi-asserted-by":"publisher","DOI":"10.1177\/0310057X8801600305"},{"key":"S0195941700087828_bib019","doi-asserted-by":"publisher","DOI":"10.1086\/646523"},{"key":"S0195941700087828_bib004","unstructured":"Occupational Safety and Health Administration. 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