Did I use alcohol swab?

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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?

Specializes in Critical Care Nursing AKA ICU.
Wow, you seem so helpful. Thanks for making me feel better about it. Do your research before saying something so rude.:rolleyes:

typical nurse response... but lets be serious you already know(hopefully) that any time you access a port you should always wipe with alchohol at least b/c of the risk of potential introduction of bacteria. if you need a forum to ask questions like "did i cause my patients sepsis?" we need to look into a different career, this reminds me of the nurse that came to me the other day saying, my patient is lethargic and isn't waking up! she failed to realize that she didn't d/c the versed/fentanyl drip when she extubated her patient :yeah:or the other nurse that said i keep on going up on the levo/vaso and the patients sbp won't respond, well it helps if the IV is connected to the patient ;)

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Specializes in ICU, Cardiac, Psychiatric.

Of course I know it introduces bacteria. That's why I posted the question--to get other nurses' insight about how much risk would it have been. I don't even remember if I did or didn't (even though I do use alcohol in every circumstance I can think of). It's what I call work-related OCD. It must be nice to never question YOUR own actions or need a second opinion to possibly help you feel better. And being that the site itself got infected, it most likely would have been microbes under the dressing, not from a flush. And aside from that, alcohol doesn't kill bacteria unless scrubbed vigorously for 2 minutes from what I've read. I don't know any nurse that does that! It doesn't seem you even bothered to read the question fully or the responses thereafter.

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Specializes in Critical Care Nursing AKA ICU.
Of course I know it introduces bacteria. That's why I posted the question--to get other nurses' insight about how much risk would it have been. I don't even remember if I did or didn't (even though I do use alcohol in every circumstance I can think of). It's what I call work-related OCD. It must be nice to never question YOUR own actions or need a second opinion to possibly help you feel better. And being that the site itself got infected, it most likely would have been microbes under the dressing, not from a flush. And aside from that, alcohol doesn't kill bacteria unless scrubbed vigorously for 2 minutes from what I've read. I don't know any nurse that does that! It doesn't seem you even bothered to read the question fully or the responses thereafter.

your right :D, no but seriously i have precepted numerous of new and old nurses and I NEVER CLAIM that i know it all. b/c that is the DANGEROUS NURSE. the thing is that we ALL make mistakes and you need to learn to accept that and learn from those mistakes and hopefully not do it again... We are put in dangerous situations EVERYDAY, so mistakes and short cuts are bound to happen!!! for example we take unsafe assignments everyday b/c it's expected of us to not b!tch and whine, and do what we are told. but reality is that people die or get injured everyday because of the situations that we as nurses are put into. yes it is very sad that's why i don't recommend anybody to come into this profession without shadowing a nurse for several days, to see what really happens in the hospital

don't know any nurse that does that either just scrub the thing as per your hospital protocol...so you won't feel guilty

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Specializes in LTC Rehab Med/Surg.
SO what are looking for? :uhoh3: yes the patient became septic b/c of you

I have just two words. Therapeutic communication.:nurse:

I've been out of school awhile, maybe they don't teach that anymore.

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Specializes in Critical Care Nursing AKA ICU.
I have just two words. Therapeutic communication.:nurse:

I've been out of school awhile, maybe they don't teach that anymore.

never heard of that before ;) left it in nursing school with alot of other things...

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I once was discussing the "tough stick" issue with an RN who was called to place an IV on me after a few too many pokes from another RN (4 was my limit that day, and I am not usually a tough stick).

Sure enough, we were talking and giggling just a bit about the situation while she was checking my forearm, she got excited saying "There's a nice one!" and just nailed it perfect, first try...

Except for the fact she was still holding the unopened alcohol pad in her hand, and then we had another little laugh about it.

Site lasted 9 days till my discharge, and never even remotely looked like it was gonna be an issue.

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Specializes in Infusion Nursing, Home Health Infusion.

In 2010 The Joint Commission added to their National Patient Safety Goals (NPSG's) that hospitals have standardized cap care. That means that all nurses are doing the same thing. INS does not currently state for how long that scrub should take place BUT at recent IV Therapy conferences and infection control conferences they have stated that all current research points to a 15 sec scrub of the cap/valve. A good scrub involves wrapping tha alcohol around the cap/ hub and scrubbing with some friction..about 10 rotations around. This is extremely important with all central lines as as much as 40% or so of infections can be coming from the intrinsic pathway.......so introduced from the cap and IV system. We have worked so hard on controlling the introduction of bacteria from extrinsic pathways...ie the skin...the latest research now...new products and updates in the standards of care will be directed toward the intrinsic sources. That is one reason we are seeing a lot of new cap and hub care cleansing products on the market. There is a difference between cleansing skin and other objects with alcohol. The skin requires a one min scrub and other objects usually require a lesser time....you get an instant kill with the alcohol...there are many factors to look at when you use a cleansing agent but I will not go into all of that. So yes do your scrub on all caps/valves and never assume skipping it once will not matter. I hear some nurses say..." well they are on antibiotics anyway" so that is an excuse for giving crappy nursing care!!!! Read Dr Marcia Ryders study on cap care...you would be surprised how designs of certain caps makes it more difficult to clean and just how much bacteria can be introduced via a cap. Goes to show you all the little things in nursing that some try to skip can have a profound effect on pt outcomes..both negative and positive

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for example we take unsafe assignments everyday b/c it's expected of us to not b!tch and whine, and do what we are told. but reality is that people die or get injured everyday because of the situations that we as nurses are put into. yes it is very sad that's why i don't recommend anybody to come into this profession without shadowing a nurse for several days, to see what really happens in the hospital

Good point! And yet, scary too. I dread the day when I become the patient in hospital setting again...

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