After removing hub protection cap, do you still need to wipe with alcohol pad?

[missjune]

I have been unsure about what is the proper way to do this. After removing the protective cap over an IV port, do you still need to wipe with alcohol before flushing with saline and giving an IV push med? Or is it still considered sterile and you do not have to clean it?

Thanks for your help!

[Flatline, BSN, RN]

What does the manufacturer say?

[Double-Helix, BSN, RN]

Edit: I misunderstood the question. This would depend on your facility's policy. In mine, we clean the port between each access, including removing the protective cap.

[Wuzzie]

I always do regardless of what the manufacturer or the policy says. I'm not going to risk it. Too many people use the caps incorrectly. Frankly, I hate those caps and think they are a bandaid for crappy nursing care. The only reason they're even in existence is because too many nurses don't take the time to properly scrub the hub.

[CCU BSN RN]

If we're talking about Curos caps, that's literally the entire point. Nurses don't actually scrub the hub for a full 15 seconds, and there are settings where that's not always feasible. As long as they're on the hub for 1 minute (and can stay up to 7 days if undisturbed.) it killed everything, your MRSA, etc. as well as if you scrubbed for 15 seconds perfectly. They're a huge life and time saver for me.

[Wuzzie]

If we're talking about Curos caps, that's literally the entire point. Nurses don't actually scrub the hub for a full 15 seconds, and there are settings where that's not always feasible. As long as they're on the hub for 1 minute (and can stay up to 7 days if undisturbed.) it killed everything, your MRSA, etc. as well as if you scrubbed for 15 seconds perfectly. They're a huge life and time saver for me.

I am completely aware of how they work and why but how can you be sure, unless you put the cap on yourself that shift, that the cap is being used correctly? Our circumstances may be different resulting in my dim view of the product. I am in an ambulatory setting. I cannot tell you the number of times a patient has told me that either they or the home health nurse put a used cap back on a line.

[klone, MSN, RN]

Op, perhaps I'm misunderstanding, are you referring to the cap that is on the port when you initially take it out of the packaging? If so, it's sterile when it comes out of the packaging, so no need to scrub the hub initially.

[DeeAngel]

Find out what your specific facility policy is, see it in writing and follow that written policy. It doesn't matter what anyone else does, you need to do it the way your facility demands.

[dread_pirate_roberts]

According to the manufacturer's recommendation AND the recommendation of the IV resource team at the hospital where I work, you still have to scrub with an alcohol wipe prior to accessing any port. We are currently only using Curos caps on our patients with central access (when they have a CVC, Port, PICC, etc, we place them on all lines and y sites, even PIVs).

The idea behind this is that we were "scrubbing a dirty hub" prior to accessing the port, and now it is kept "clean" by the cap, but we're "scrubbing the clean" instead. At 24 cents per cap, they're an expensive answer to the CLABSI question, but anything that can decrease risk of infection for my patient is A-OK with me.

[Julius Seizure]

According to the manufacturer's recommendation AND the recommendation of the IV resource team at the hospital where I work, you still have to scrub with an alcohol wipe prior to accessing any port.

I'm not sure this is true. I can't find any info saying that you still need to scrub on the Curos website. I did find this PDF on "how to use" which states that the line may be accessed immediately after removal of the cap...and nothing about scrubbing the line first.

My hospital also had a policy to scrub after removal, but I don't necessarily agree with that. Curos caps are said to achieve a 99.99% reduction in microbes, and I don't think that me touching the cap with my gloves and little alcohol swab are going to do anything to improve upon that. If anything, I am going to make it dirtier by manipulating the hub again - even with non-sterile gloves.

Furthermore, Curos caps are said to be beneficial because they provide a physical barrier, save time, and eliminate the problem of poor scrubbing technique. If you scrub after removing....you might as well have not used the Curos cap at all.

[Irish_Mist, BSN, RN]

I scrub the hub with alcohol after removing the green curo caps. It's just a small, extra step to ensure the hub is clean and with CLASBI being a risk, it's just a few extra seconds.

[dread_pirate_roberts]

I can definitely see where you're coming from because whether to still scrub or not isn't readily available on their website. The informational booklet (from the manufacturer) my SICU received stated that we were still to scrub, but perhaps that information is already out of date? Great information, thank you!