Scrub….don’t wipe!!!

According to the 2011 CDC guidelines section on “needleless intravascular catheter systems” statement #4 :

“Minimize contamination risk by scrubbing the access port with an appropriate antiseptic (chlorhexidine, povidone iodine, an iodophor, or 70% alcohol) and accessing the port only with sterile devices. Category 1A” 

This is an update to their 2002 guidelines …minimize contamination risk by wiping the access port…

Recently, published studies indicate needleless connectors could be sites of microbial contamination when applied to catheter hubs contributing to CR-BSI .  Many factors have to be considered and one is the design of the connectors. An important infection control prevention is to ensure proper disinfection of connectors prior to each access.

Many nurses  admit they don’t even properly “wipe” connectors prior to each access and now they have to scrub? Scrubbing needleless connectors prior to each access is just good practice. Let’s think about who’s going to benefit from scrubbing connectors if you are tempting not to.

So now the question is….what is the technique and for how long do you scrub? While the optimal technique and disinfection time has not been determined, many infection control resources such as the IHI (Institute for Healthcare Improvement) suggest the following: (adapted from the “scrub the Hub” poster)

• Perform hand hygiene.
• Put on clean gloves prior to accessing the line.
• Perform a 30-second “hub scrub” using alcohol and friction in a twisting motion on the hub as if you were juicing an orange.
• Perform procedure (infuse medications or draw blood)
• Discard gloves and perform hand hygiene.

So will you scrub or wipe?