Looking for a definition of "access" as in "Disinfect needleless connector before accessing the catheter".
Does "access" equal "entry into" the catheter?
Is "access" the set of activities that follow the initial disinfection of the needleless connector, for example flushing with saline, then drawing a blood sample, then flushing with saline, and then flushing with heparin, each with different syringes? Is this ONE access, or is this FOUR accesses?
Is this defined anywhere? Any evidence that supports one definition over the other?
As a member of the committee I can definitely state we intended it to mean each time the system is entered. What you described would be 4 accesses. See Standard 34, standard statement 34.2 "Disinfect the needleless connectors prior to each entry into the device."
Lynn
Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
I understand this; however, the section G. 3. talks about multiple accesses requiring disinfection each time, is listed only as Committee Consensus, the lowest form of evidence. I am having difficulty getting support for this definition of access. CDC, Joint Commission, SHEA, etc. all say to disinfect the needleless connector prior to access. I believe that this is strong evidence to disinfect prior to each ENTRY, but others disagree, since only INS and a recent article by Moreau and Flynn say to do it each time, with the only support being consensus.
Wendy Erickson RN
Eau Claire WI