{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:11:59Z","timestamp":1787019119503,"version":"build-2736575974"},"reference-count":32,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2024,8,3]],"date-time":"2024-08-03T00:00:00Z","timestamp":1722643200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2024,8,3]],"date-time":"2024-08-03T00:00:00Z","timestamp":1722643200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Vasc Access"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To compare relative risk (RR) of central line-associated bloodstream infection (CLABSI) between hospitals using Clave needleless connector technologies (NCT) and comparator hospitals using non-Clave NCT. And, to estimate avoided CLABSIs, mortality, and cost savings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Needleless connectors, while protective against needlestick injury, have long been implicated as a potential risk for CLABSI. Significant RR reduction of CLABSI among the many NCT has not been clinically demonstrated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>The U.S. Healthcare-Associated Infections database was accessed for CLABSI data for calendar year 2019 via the Centers for Medicare and Medicaid Services website. This dataset was merged with the Clave NCT manufacturer\u2019s 2019 database to identify hospitals purchasing Clave NCT (MicroClave\u2122, NanoClave\u2122, Clave Neutron\u2122, Clave\u2122, Microclave\u2122 Clear) and non-Clave NCT comparator hospitals. Sub-analysis of Clave NCT hospitals included: (1) Clave NCT mixed-use and (2) Clave high-volume use hospitals. The standardized infection ratio (SIR) was generated to estimate CLABSI RR after adjusting for intern\/resident-to-bed-ratio (IRB), care location, and hospital demographics. Using the RR, avoided CLABSIs, mortality, and cost savings were calculated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      A total of 2987 eligible hospitals (1288 Clave NCT, 1699 non-Clave NCT) with 17,452,575 central line-days were evaluated. All three Clave NCT hospital groups showed a statistically significant reduction in RR compared to the non-Clave NCT hospitals. The RR in Clave NCT hospitals was 0.93, a 7% decrease in CLABSI risk (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.02). In the Clave NCT subgroups, mixed-use hospitals RR was 0.93, a 7% reduction (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.04), while the Clave NCT high-volume hospitals experienced a 19% reduction, RR 0.81 (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.04). An estimated 563 CLABSIs and 84 related deaths were avoided with use of Clave NCT and $27,095,231 in cost savings.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The use of the Clave NCT, in and of itself, is an effective risk reduction strategy for CLABSI prevention, reduced mortality, and substantial cost savings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/11297298241261951","type":"journal-article","created":{"date-parts":[[2024,8,4]],"date-time":"2024-08-04T02:27:18Z","timestamp":1722738438000},"page":"1194-1205","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Choice of needleless connector technology as a risk reduction strategy for catheter related bloodstream infection, mortality, and cost: A secondary data analysis"],"prefix":"10.1177","volume":"26","author":[{"given":"Marcia","family":"Ryder","sequence":"first","affiliation":[{"name":"Ryder Science, Brentwood, TN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0652-1988","authenticated-orcid":false,"given":"Jason","family":"Battle","sequence":"additional","affiliation":[{"name":"ICU Medical, San Clemente, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,8,3]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra2213296"},{"key":"e_1_3_3_3_2","unstructured":"Agency for Healthcare Research and Quality. Estimating the additional hospital inpatient cost and mortality associated with selected hospital-acquired conditions. AHRQ Publication No. 18-0011-EF November 2017."},{"key":"e_1_3_3_4_2","unstructured":"Centers for Disease Control and Prevention. Current HAI progress report: 2021 national and state healthcare-associated infections progress report https:\/\/www.cdc.gov\/hai\/data\/portal\/progress-report.html (2022 accessed 27 September 2023)."},{"key":"e_1_3_3_5_2","unstructured":"Leapfrog Hospital Safety Grade. New Leapfrog hospital safety grade reveals significant increase in healthcare-associated infections and worsening patient experience during COVID-19 pandemic https:\/\/www.hospitalsafetygrade.org\/about-our-movement\/newsroom\/display\/1155271 (2023 accessed 27 September 2023)."},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2023.03.016"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2022.65"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2022.02.041"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2021.362"},{"key":"e_1_3_3_10_2","first-page":"65806","article-title":"Notice for public comments on Healthcare-Associated Infections (HAI) national action plan targets","author":"Department of Health and Human Services","year":"2022","unstructured":"Department of Health and Human Services. Notice for public comments on Healthcare-Associated Infections (HAI) national action plan targets. Federal Register. 15 November 2022; 65806.","journal-title":"Federal Register"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2022.87"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1097\/NAN.0000000000000396"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1177\/11297298211023274"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2023.60"},{"key":"e_1_3_3_15_2","unstructured":"Centers for Medicare and Medicaid Services. Hospital compare: healthcare-associated infections https:\/\/data.cms.gov\/provider-data\/topics\/hospitals (accessed 27 January 2021) Published 2019."},{"key":"e_1_3_3_16_2","unstructured":"Centers for Medicare and Medicaid Services. Files for FY 2019 final rule and correction notice https:\/\/www.cms.gov\/medicaremedicare-fee-service-paymentacuteinpatientppsacute-inpatient-files-download\/files-fy-2019-final-rule-and-correction-notice (accessed 27 January 2021) Published 2019."},{"key":"e_1_3_3_17_2","first-page":"59","article-title":"Measuring teaching intensity with the resident-to-average daily census ratio","volume":"14","author":"Phillips SM.","year":"1992","unstructured":"Phillips SM. Measuring teaching intensity with the resident-to-average daily census ratio. Health Care Financ Rev 1992; 14: 59\u201368.","journal-title":"Health Care Financ Rev"},{"key":"e_1_3_3_18_2","unstructured":"CDC Web Archive. Lesson 3: measures of risk Section 5: measures of association. https:\/\/archive.cdc.gov\/#\/details?q=lesson%203:%20measures%20of%20risk&start=0&rows=10&url=https:\/\/www.cdc.gov\/csels\/dsepd\/ss1978\/lesson3\/section5.html (accessed 7 July 2023) Published 2012."},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-019-05592-5"},{"key":"e_1_3_3_20_2","first-page":"51","volume-title":"Modern epidemiology","author":"Greenland S","year":"2008","unstructured":"Greenland S, Rothman KJ, Lash TL. Measures of effect and measures of association. In: Rothman KJ, Greenland S, Lash TL (eds) Modern epidemiology. 3rd ed. Philadelphia, PA: Wolters Kluwer Health\/Lippincott Williams & Wilkins, 2008, pp.51\u201370.","edition":"3"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1002\/0470023589"},{"key":"e_1_3_3_22_2","first-page":"243","article-title":"Vital signs: central line-associated blood stream infections","volume":"60","author":"Centers for Disease Control and Prevention","year":"2011","unstructured":"Centers for Disease Control and Prevention. Vital signs: central line-associated blood stream infections. MMWR Morb Mortal Wkly Rep 2011; 60: 243\u2013248.","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1086\/648418"},{"key":"e_1_3_3_24_2","first-page":"30","article-title":"Choosing the best design for intravenous needleless connectors to prevent healthcare-associated bloodstream infections","volume":"14","author":"Jarvis WR.","year":"2010","unstructured":"Jarvis WR. Choosing the best design for intravenous needleless connectors to prevent healthcare-associated bloodstream infections. Infection Control Today 2010; 14: 30\u201331.","journal-title":"Infection Control Today"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1097\/NAN.0b013e3181c65cc9"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1177\/1757177416657164"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2014.08.018"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.iccn.2021.103182"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.idh.2021.04.004"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2023.04.001"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofz111"},{"key":"e_1_3_3_32_2","first-page":"84","article-title":"Comparing outcomes and costs of medical patients treated at major teaching and non-teaching hospitals: a national matched analysis","volume":"36","author":"Silber JH","year":"2021","unstructured":"Silber JH, Rosenbaum PR, Niknam BA, et al. Comparing outcomes and costs of medical patients treated at major teaching and non-teaching hospitals: a national matched analysis. J Gen Intern Med 2021; 36: 84\u201391.","journal-title":"J Gen Intern Med"},{"key":"e_1_3_3_33_2","doi-asserted-by":"publisher","DOI":"10.1111\/1468-0009.12502"}],"container-title":["The Journal of Vascular Access"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/11297298241261951","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/11297298241261951","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/11297298241261951","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T03:24:58Z","timestamp":1777692298000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/11297298241261951"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8,3]]},"references-count":32,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025,7]]}},"alternative-id":["10.1177\/11297298241261951"],"URL":"https:\/\/doi.org\/10.1177\/11297298241261951","relation":{},"ISSN":["1129-7298","1724-6032"],"issn-type":[{"value":"1129-7298","type":"print"},{"value":"1724-6032","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,8,3]]}}}