Ms Emily Larsen1,2,3,4,5, Ms Deanne August2,4,5, Professor Samantha Keogh2,4,6, Dr Julie Flynn7, Professor Amanda Ullman2,4,5,8, Professor Nicole Marsh1,2,3,4,5,6, Professor Alexandra McCarthy5,9, Professor Claire Rickard1,4,5,10
1School of Nursing and Midwifery, Griffith University, Brisbane, Australia
2Nursing and Midwifery Research Centre, Royal Brisbane and Women’s Hospital, Brisbane, Australia
3Patient-Centred Health Services, Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
4Alliance for Vascular Access Teaching and Research Group, Griffith University, Brisbane, Australia
5School of Nursing, Midwifery and Social Work, University of Queensland, Brisbane, Australia
6School of Nursing, Queensland University of Technology, Brisbane, Australia
7School of Nursing and Midwifery, University of Southern Queensland, Ipswich, Australia
8Children’s Health Queensland, Brisbane, Australia
9Mater Research Institute, University of Queensland, Brisbane, Australia
10Herston Infectious Diseases Institute, Metro North Health, Brisbane, Australia
Introduction: Needleless connectors (NCs) help to provide a safe (needle-free) link between vascular access devices, syringes, and intravenous infusion sets. Despite this, NC have been associated with catheter-related bloodstream infections, often related to poor decontamination practices. Nurses are the most frequent users of NC; this study aimed to explore their attitudes, techniques, and practices around the use and decontamination of NCs.
Methods: Using qualitative methods, we conducted seven focus groups (n=4-6, each) in cancer and surgical units of the Royal Brisbane and Women’s Hospital (Queensland, Australia) between January and March 2019. The clinical units selected had recently taken part in a randomised controlled trial of three different methods of NC decontamination. Focus group transcriptions were analysed using content analysis.
Results: In total, n=30 participants were included in the seven focus groups (duration, 16 and 20 minutes). Six major themes were identified including: ‘safety and utility’; ‘terminology and technological understanding’; ‘clinical practice determinants’; ‘decontamination procedures and influencers’; ‘education and culture’; and ‘research and innovation’. Nurses overwhelming reported good intentions toward their decontamination and NC maintenance practices (such as NC replacement), however competing demands on their time was a barrier. Common trademarked phrases were easily articulated (e.g., ‘Scrub the Hub™),’ however specific local guidelines (e.g., time to clean, time to dry) were less well understood.
Conclusion: Understanding attitudes, techniques, and practices for the use and decontamination of NCs is important to enable targeted quality improvement strategies. Our study identified several important areas for improved education, and behavioural change.
Biography: Emily Larsen is a Research Fellow, Vascular Access, with a joint position between the Royal Brisbane and Women’s Hospital, and Griffith University. Since 2014, Ms Larsen has managed over 40 single and multi-centre clinical trials, cohort studies and qualitative inquiries. Her current research focus explores the role, and development of Patient Reported Outcome and Experience Measures for vascular access devices.