Luer Lock Connections on Infusion (IV) Lines in Hospitals Improve Patient Safety

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Healthcare Safety Practice of SearchPath - Since the Infusion Nurses Society (INS) made the recommendation in 2011 for hospitals to move away from luer slip connections on IV lines where possible, manufacturers have slowly been replacing products that have traditionally included a luer slip with products that have a luer lock connection.

A luer slip connection joins two pieces of infusion disposable products together through a compression fit where the male end is tapered and fits into the female end using pressure (or torque). For instance, an IV/luer slip connection is commonly used on a 1mL luer slip syringe in the Neonatal ICU (NICU). Since many NICU patients often need very small doses of medications, I mL luer slip syringes are still used in some institutions because of their dosing precision. Furthermore, these syringes are often placed onto syringe pumps for delivery. These devices require a great deal of force (as high as 50psi or over 2500mmhg) in order to move a 1mL syringe plunger forward to deliver the medication, further leading to the potential disconnect.

A luer lock, on the other hand, works much like a hose connecting to a spigot where one end literally screws onto the other end, making the connection more secure. The INS, in 2011 guideline #26.3 recommended the use of a luer locking connection on IVs to increase patient safety saying “all add on devices shall be of luer lock design to ensure a secure junction”.

Most manufacturers of IV tubing have pared back production of luer slip connectors in favor of the safer luer locks as hospitals have made the conversion.

Other manufacturers have adhered to the INS recommendations while providing additional patient safety features. One case in point is a product that is currently being manufactured and marketed by Ivera Medical Corporation (Carlsbad, CA), a certified minority owned business. Their product, the Curos® Port Protector, luer locks onto a needleless IV port (or IV site) and is designed to bathe the site in 70% isopropyl alcohol , disinfecting the IV site to reduce the number of organisms that may enter a patient’s bloodstream. CEO Bob Rogers explains the reason why Ivera chose to make their Curos® port protector a luer lock connection verses a luer slip connection, saying “The choice to use luer lock was a simple one for us. All needleless luer activated valves are constructed with a luer lock structure. Luer lock provides a secure connection, a connection that cannot be pulled apart.”

Hospitals continue to look for ways to reduce patient harm by providing them with products that are designed to improve patient safety. Reduction of luer slip connectors on IV lines is one trend that seems to have taken hold.

Shawn Tolan is Senior Partner with the Healthcare Safety practice of SearchPath, an Executive Search Firm based in Atlanta, GA. Prior to starting his search firm, Shawn spent 25 years in sales and marketing, working for medical device companies whose products improved patient safety. He can be reached at stolan@searchpath.com or by phone at (678) 668.7003

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Shawn Tolan
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