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Recommendations from the Centers for Disease Control [8], the Agency for Healthcare Research and Quality [9], the Society for Healthcare Epidemiology of America [10], and the Infusion Nurses Society [11, 118] state that NC should be consistently and thoroughly disinfected using mechanical friction with 70% alcohol, alcoholic chlorhexidine, or povidone iodine prior to each access of an intravascular device and listed in evidence as a Category 1A. 2.1. Goal The goal of this review is to assess current literature related to disinfection of NC to establish recommendations that promote aseptic find more access, reducing infection risk for the patient. 2.2. Search Methodology The purpose of this systematic review was to evaluate the supporting evidence for disinfection practices of NC, catheter hub, stopcock, and side ports that reduce the transfer of microorganisms through intravascular device access. This report is based on an electronic systematic literature search and review of published materials from Pubmed, Medline, Scopus, Ovid, jStor, CINAHL, Cochrane, Athens, and ScienceDirect by cross-referencing these key terms for years 1977�CDecember 2014. High level evidence from RCTs that tested ��cause and effect�� relationships between different disinfection approaches for NC and patient infection was initially sought. Since no RCTs were found, lower level evidence including clinical and in vitro (laboratory) studies was reviewed, as long as these included reporting of quantitative data. Broad MeSH search term ��disinfection�� and ��needleless connector�� combinations were used with additional keywords listed below: disinfection, antiseptic, alcohol, chlorhexidine, http://www.selleckchem.com/products/MS-275.html and anti-infective agents, intravenous, intravascular, and vascular access, hub, catheter hub, scrub the hub, intravenous connector, NC, luer activated device, and mechanical valve, aseptic practices, contamination, and compliance, education, staff education, and medical education, infection, infection prevention, catheter related infections, CLABSI, bloodstream infections, bacteremia, sepsis, and cross-infection, catheter maintenance and line care, insertion and bundle, intravenous technology, catheter cap, access port, disinfecting cap, antimicrobial cap, hub protection cap, and port protector, Infection prevention guidelines and recommendations. Quinapyramine Additional studies were cross-referenced through manual search. Conference posters and abstracts were included in the review. Manufacturers websites of disinfection ports and two manufacturers (Excelsior Medical, Neptune, NJ; Ivera Medical Corporation, San Diego, CA) were contacted directly requesting all published materials and posters on disinfection products. There were no identified formal published systematic reviews of the effectiveness of NC disinfection practices, indicating a knowledge gap in this area. Search results were evaluated by title, abstract, and content.