depends on the agent you use, appropriate contact and drying time,
and — most important — friction. We held a staff in-service to review
the steps as outlined by The Joint Commission.
First things first. Perform hand hygiene and don sterile gloves (as
required). Then open a new alcohol or chlorhexidine pad to disinfect
the catheter hub/port/vial. Unless directed otherwise by the manufac-
turer's instructions, rub for 10 to 15 seconds or for 30 twists, generat-
ing friction by scrubbing in a twisting motion as if you were juicing an
orange (15 seconds is longer than you think!). Make sure you scrub
the top of the hub/port/vial well, not just the sides. Never reuse alco-
hol prep pads. Let the hub/port/vial dry. Prevent it from touching any-
thing while drying. Now you're set to infuse medication. Finally, don't
forget to perform hand hygiene after you discard the gloves.
As an added precaution to reduce bloodstream infections in
patients, you can use alcohol-impregnated port protectors, scrubbing
devices and needleless neutral displacement connectors in addition to
scrubbing the hub.
OSM
Ms. Holder (bholder@andrewsinstitutesc.com) is the Quality Improvement
coordinator at the Andrews Institute Ambulatory Surgery Center in Gulf
Breeze, Fla.
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