Cleaning Suction Canisters in Home Care

[LuLu2008]

I have my first home care patient with a trach, ventilator, oxygen and a humidifier. There are many cords, tubes, buttons to push, etc. and it is a bit overwhelming, but a respiratory therapist works with the family in that area with the exception of changing the trach, which is a nursing task.

Here is my concern: I am attempting to implement infection prevention measures. I have asked the C.N.A. to wash the suction canister (which collects the aspirated materials) with soap and water after emptying it every shift. The family insists that only hot water be used because that is what "respiratory" told them to do, otherwise the patient is at risk for inhaling the soap residue.

What is the community standard in this case? If the client gets a respiratory infection, can I be held responsible because I did not make sure all the equipment was properly cleaned? How do I get the family to look at the printed documentation I can produce from several sources recommending cleaning with soap and water?

[caliotter3]

The primary nurse on a case where I used to work told me that she instituted a night shift cleaning routine for the respiratory equipment after the patient had been hospitalized with pneumonia one time. She used to wash everything in hot soapy water, rinse it well, and soak it in Control III for a minimum of two hours, rinse and allow to air dry. Everything, and I mean everything, was cleaned this way every night. And in the 18 or 20 years that she had been following this protocol, she proudly stated that the patient had not gone to the hospital again with pneumonia. To tell you the truth, while I think this might be unnecessary, I tend to agree with her methods. They work.

[nursel56]

I've had patients with trachs tell me they can feel the irritation of soap residue and even Control III, so it's possible the family was told something like that.

Here is what we usually do-- and this includes the entire circuit unless respiratory does that part-if the humidifier and rinsing water container aren't as clean as the suction cannister it kind of defeats the purpose.

Suction cannisters, humidifier chamber, non-disposable tubing-- wash in mild dish soap and water, scrub crevices with a brush, especially the underside of the lid with the float stopper. Let soak in 50-50 white vinegar and water for at least 15 minutes. Rinse with plain water. Air dry.

Switch out the suction cannister and humidifier chamber for new clean ones every 24 hours, traditionally night shift does this-- but often they're too busy :zzzzz - best to remind often. Throw out funky suction tubing and Yankauers.

It is truly amazing how long a patient can go without getting infections with this regimen as opposed to practically picking up your c.diff and MRSA at the hospital door these days.

[anticoagulationurse]

suction... Gack! (I know, not helpful)