Why must one scrub in between sequential port accesses if the hub has been scrubbed sufficiently (10-15 seconds of vigorous scrubbing) before first entry? If each "touch" is with a sterile tip in sequential access, why scrub each time? Thank you, Nancy
The SASH or SAS flushing protocol requires 6 or 8 connections and disconnections. You might get away with scrubbing before the first saline flush and then give the medication. But that medication tubing has been connected for 30-60 minutes and it has been out of your control and therefore in contact with bed, clothing, possibly body fluids, etc, etc. So it is imperative that you clean again when you give the final saline and heparin flushes. I would still prefer to clean with each connection with 4 separate alcohol pads.
Lynn Hadaway, M.Ed., RN, BC, CRNI
www.hadawayassociates.com
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
Can an alcohol pad get "contaminated"?
I would think that by their nature they couldn't.
Patrick Cassidy, RN
Bloomington Hospital of Orange County
Patrick Cassidy, RN
Infusion Therapy
IU Healthcare Paoli Hospital
Yes, they certainly can. Many are not made with a sterile process. And in the recent past there have been recalls of alcohol pad products due to intrinsic contamination from the manufacturing process.
Lynn Hadaway, M.Ed., RN, BC, CRNI
www.hadawayassociates.com
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
Sheila Fiscus, RN, CRNI, Seton Family of Hospitals, Austin, TX
When giving an IV "push", requiring saline, med, saline, do you recommend disinfection with new alcohol pad between each syringe? And is there any research to support this?
Sheila Hale, MSN, RN, CRNI, VA-BC, Austin, TX
Yes, the standards state clean before each access. So in my opinion that means 4 alcohol pads and 4 cleanings to administer a SASH or SAS procedure. Just like many things, this is based on expert opinion and not research, however expert opinion is a form of evidence, albeit the lowest form on the hierarchy. There is also no research to support the best technique - one swipe, multiple back and forth or circular motion and the length of drying time. The length of scrubbing time is only supported by one small bench study that found 15 seconds was adequate.
Lynn Hadaway, M.Ed., RN, BC, CRNI
www.hadawayassociates.com
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