Did I use alcohol swab?

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Specializes in ICU, Cardiac, Psychiatric.

I've been worrying all week about a patient who got an infection at the IV site then became septic from this site. I'm not even sure if I had this patient when she had the bad IV but I keep racking my brain to remember if I forgot to use an alcohol pad before I flushed the iv cap!

I've read some posts about people not using alcohol routinely etc. I always do but just have to wonder if I didn't for some reason!

Any insight?

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Specializes in NICU.

Not sure what kind of insight you're looking for, as nobody here can guess whether you scrubbed the port or not. How long have you been working? Obviously, "always do" means something different for someone on the floor for five years as opposed to a week; that said, it's not unlikely that you did out of muscle memory and forgot about doing it if it's so habitual.

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Honestly, at this point, you can't remember if you did or didn't and even if you did, it wouldn't change the situation. Just chalk this one up to experience and know you'll be careful to be sure you do what you usually do.

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Specializes in ICU, Cardiac, Psychiatric.

I guess for insight I mean if I didn't use the alcohol swab, would this have caused the iv site to get infected itself?

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Specializes in CVICU.

It's possible, but really, I think there are some studies out that show that it doesn't really make much difference. I always swab because I don't want to be contributing to the risk of infection. But did one incident of not swabbing cause this infection? Probably not. It's not worth beating yourself up about.

So yes, you could have caused it, but you may also have had no effect on it at all. Infections in IV sites happen.

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Specializes in home health, dialysis, others.

Usually an IV site becomes infected due to microbes under the dressing, not because of an unswabbed port. Unless someone has deliberately soiled the ports, or left them wet with fluid, they are fairly clean.

Also, please consider all the other 'stuff' going on with the patient. It's just not very likely that you had a part in this.

By the way, I am a diabetic, and don't use alcohol swabs for any purpose. I wash my hands before I stick myself. I bathe regularly, so it's not likely that my belly, thighs and upper arms are very dirty. I try very hard to not touch the stopper on the bottles, and if I think it may be contaminated, I simply wipe the top with a clean cloth. Nine years, no problems.

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Specializes in ER.

Many different nurses probably used that line. Using alcohol is very important, but I doubt one instance of not using it would cause sepsis. I'm not downplaying the importance of alcohol, but people who develop full blown sepsis usually have more than one issue going on. Use this as a learning tool and always always use alcohol in the future.

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Specializes in CVICU.

I just wanted to add that I've noticed recently that subclavian central lines tend to fall into the armpit when not in use, so I'm especially careful to alcohol swab those, because as we all know from our MRSA videos, that stuff likes to live in noses and armpits.

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Specializes in Emergency Nursing.

If using an alcohol swap to clean the port is something that you do regularly then most likely you did it without thinking and your just doubting yourself now. We all know that using the alcohol swab to clean the port is good practice because it reduces the rate of infection but most likely this infected IV site was infected under the dressing and not from the tubing because of all the bacteria that exist on the surface of the skin. I think the lesson to take away from this is that we should always try to be diligent about IV site care which includes dressing changes when appropriate, using an alcohol swab to clean port sites and removing IVs that show signs and symptoms of infiltration, phlebitis or infection. I've worked on a Med/Surg floor and seen patients with peripheral IVs that have been in for almost a week without being changed and are visibly soiled and when I asked the nurse(s) about it I was told "Well the IV is still patent." or "They are a really tough stick so we can't change the site." In my mind, I find that to be a much more troubling potential source for infection.

!Chris :specs:

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Specializes in ICU, Cardiac, Psychiatric.

I had also read in various sources that alcohol does not sterilize the port, or even kill all bacteria on the port. So in essence, aren't we really introducing bacteria to the bloodstream with any flush or access at all?

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Specializes in Critical Care Nursing AKA ICU.
I've been worrying all week about a patient who got an infection at the IV site then became septic from this site. I'm not even sure if I had this patient when she had the bad IV but I keep racking my brain to remember if I forgot to use an alcohol pad before I flushed the iv cap!

I've read some posts about people not using alcohol routinely etc. I always do but just have to wonder if I didn't for some reason!

Any insight?

SO what are looking for? :uhoh3: yes the patient became septic b/c of you

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Specializes in ICU, Cardiac, Psychiatric.

Wow, you seem so helpful. Thanks for making me feel better about it. Do your research before saying something so rude.:rolleyes:

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