Hello all! I would like input from anyone with experience (good and bad) in acute care with inpt's having alcohol pads and sterile end caps in every patient room.
I understand new and exciting products are available for bedside active and passive cap disinfection. These products success rate to prevent BSI and CLBSI are clearly impacted by staff's accessablity. I am a vascular access nurse in a 300 bed acute care hospital owned by HCA.
Conservatively speaking, if the average Med Surg nurse on an average day access IV lines 20-35 times in 12 hours , why are they expected to levitate the supplies they need? Examples include and are not limited to: No NS in pockets- "it might change temperature" any studies or the patient can drink it-any RCA's on a death over NS since it is OTC in every store in the US, no alcohol in rooms- the patient can suck on the pads- yet they don't drink their body wash, handgel or handsoap by the sink?? Just keep the sterile end caps in your pocket-hmmm any package testing after a couple hours in a nurse's pocket? But the avergae person uses the bathroom 3-5 times in twelve hours and demands there be toilet paper, hand soap and hand towels when they get there. Tell a surgeon he must do a hand scrub, but the sink is in the parking lot. We have heard all sorts of perverse excuses to prevent effective nursing care. Let's start with the basics.
I am in the process of collecting data to support the need of direct access at the bedside for alcohol pads and sterile end caps kept in clear acrylic boxes in every patient room. My dream is to have saline flushes aswell, but small bites, right?
While nursing has high volume, high stress and high speed demands for very routine things, it has always frustrated me as a health care professional that there is no urgency or consideration for the frontline bedside nurse to expidite their job effiently. Specifically with IV and CVC/PICC line care and access. Ease of use is never considered.
Why is it if you put CHG or alcohol in a new "cap" is now okay to keep on IV poles at the bedside? Why is it not a Std of Care to have at the bedside as wipes/pads now?
This may be a regional or corporate thing, but I find with talking and networking that bedside nurses are lone rangers screeching down the hallway witheverything they need on their heads to make every agency happy. What about real patient saftey???? If the nurse does not have what they need avaiable, it won't get used.
I like opening statements that include "evidence based". Where is the evidence to support NOT having saline flushes, alcohol pads and sterile end caps at the bedside? They are all components of expected care multiple times a day throughout a shift for acute care. Blood stream infections hurt and kill loved ones. Evidence supports poor technique contributing to deaths and injury, but I see only expensive new products that my take years for hosptals to decide whether they will buy them or not. Time is of the essence.
I am excited to have the opportunity to trial alcohol and sterile end caps on a unit at my hospital. I believe in cost effective and efficient care.I also believe nurses need more help and resources to complete safe and effective care. Please reply with any info you might fell is helpful.
Kathy Mailloux,RN
TMC-VAT