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bartina
hub cleaning

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

lynncrni
The SASH or SAS flushing

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, BC, CRNI

Lynn Hadaway Associates, Inc.

126 Main Street, PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

POC
Can an alcohol pad get

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

lynncrni
Yes, they certainly can.

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, BC, CRNI

Lynn Hadaway Associates, Inc.

126 Main Street, PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

Sheila
Sheila's picture
Sheila Fiscus, RN, CRNI,

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, BSN, RN, CRNI, VA-BC, Austin, TX

lynncrni
Yes, the standards state

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, BC, CRNI

Lynn Hadaway Associates, Inc.

126 Main Street, PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

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