5-Year Study Shows Hartford Hospital cut tPA by 71.3%


Lenexa, Kansas (May 19, 2022)—New research published in the Clinical Nurse Specialist journal shows the vascular access team at Hartford Hospital cut the use of tissue plasminogen activator (tPA) by 71.3%, decreased needleless connector consumption by 41% and saved more than $350,000 using Lean Six Sigma methodology (waste, variables, errors). The CLE3AR study moniker is derived from Central Line patency, the three Es (E3) of Lean Six Sigma (efficiency, effectiveness, and economics) and the inclusion of Anti-Reflux technology. The study examined 5 years of the hospital’s vascular access data to review progress made since Lean occlusion management was implemented. The hospital benchmarked and then enacted changes to identify and address waste, variability and defects associated with IV catheter occlusions.

Intraluminal thrombotic catheter occlusions are an important focus area for improvement. These occlusions increase patient risks, including delayed treatment, morbidity, mortality, and higher healthcare costs. Beginning in 2015, all central venous catheter occlusions at Hartford Hospital were assessed by a vascular access nurse specialist. A catheter patency algorithm was created to determine if treating with tPA was necessary. Next, negative displacement needleless connectors (NCs) were replaced by anti-reflux NCs. Unlike other types of NCs, the TKO anti-reflux NC contains a diaphragm that prevents unintentional blood reflux and other complications associated with intraluminal thrombotic catheter occlusion.

The study included a total of 159,934 central line days between 2014 and 2020. Prior to the study, 1,428 patients received tPA, while only 410 patients received tPA in 2020. The hospital achieved a 71.3% reduction in tPA used for occlusions. Additionally, 110,593 NCs were used in 2014, but by switching to an anti-reflux NC, only 66,100 were used in 2015. These results remained constant during the 5-year study period, resulting in a 41% decrease in consumption with an average annual usage of 65,400 units. These two interventions led to an estimated $356,005 in savings. In 2014, it is estimated that occlusion costs were $92,820. By 2015, occlusion costs were $41,496, and by 2020, costs dropped to $26,650.

This study further demonstrates that anti-reflux technology combined with effective management and treatment of catheter occlusions will improve patient safety and outcomes.

Read the study.

About Nexus Medical

Founded in 2001, Nexus Medical invented the anti-reflux category in needleless connectors to solve the unintended consequences of blood reflux in IV catheters, including intraluminal thrombotic occlusions, catheter failure, and infections. With more than 45 published studies and national conference poster boards, the Nexus TKO anti-reflux technology is an evidence-based way to simplify the complexity of IV therapy and improve patient safety. For more information, call (913) 451-2234 or email tkocustserv@nexusmedical.com.


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