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OCD about central line infections - need perspective!

Nurses   (1,507 Views | 14 Replies)
by laceysrn laceysrn (New) New

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Hi allnurses! I have been a nurse for almost 2 years now on a busy med-surg floor. It's going well overall, but I'm struggling with overthinking my IV care. I'm a little OCD at baseline, and especially when I'm caring for immunesuppressed patients, I can get into a bad cycle. I think to myself -" did I touch the hub? I'm not sure, so I better clean it..." this cycle can be a waste of time and supplies though. Everyone always says "that's good!" When I say I'm OCD about infection, but I think it's getting out of hand...I worry that I may have touched a patient's line, and now they're going to go septic, all because of me, and it distracts me from the actual important things!

can anyone help me with some mental tools or perspective? Thank you!!

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blondy2061h has 15 years experience as a MSN, RN and specializes in Oncology.

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Have you actually been diagnosed with OCD? Have you sought help from a mental health professional?

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1,094 Posts; 7,645 Profile Views

Does your hospital have a policy regarding how long to scrub and allow the hubs to dry? Following that is going to be your best bet to combat infection. Instead of overthinking and making up what you think is safest.

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KRVRN is a BSN, RN and specializes in NICU.

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I think you missed your calling as a NICU nurse...

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With a mortality rate of 10-25% (higher than breast cancer) a touch of OCD when it comes to preventing CRBSI is good. Scrubbing before every subsequential access is the standard of care so worrying about whether you touched the hub or not should not be a concern.

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I think we all have that one thing in nursing we are more than normally paranoid about.

Mine is pulling meds. I used to be an LPN in LTC, we did not have scanners or the pyxis like we do in the hospital. So it was essential to triple check the meds you pulled from the med cart. Now that I'm in acute care, using the pyxis, it should be quicker but I still was taking a long time to pull meds because I'm so paranoid about getting too used to technology and relying on that instead of what I had been doing as an LPN for years.

I actually sought out my clinical educator. She showed me the efficient, safe way to double check my meds while scanning and while pulling the meds. It made my med pass much quicker with less paranoia since I know I was shown the best/safest way to do it.

Perhaps doing something similar could help your paranoia? Your clinical educator or another nurse could show you their tricks to make sure every thing is kosher with your iv care the first time you do it and prevent repeating steps that aren't needed.

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1,701 Posts; 17,730 Profile Views

Hi allnurses! I have been a nurse for almost 2 years now on a busy med-surg floor. It's going well overall, but I'm struggling with overthinking my IV care. I'm a little OCD at baseline, and especially when I'm caring for immunesuppressed patients, I can get into a bad cycle. I think to myself -" did I touch the hub? I'm not sure, so I better clean it..." this cycle can be a waste of time and supplies though. Everyone always says "that's good!" When I say I'm OCD about infection, but I think it's getting out of hand...I worry that I may have touched a patient's line, and now they're going to go septic, all because of me, and it distracts me from the actual important things!

can anyone help me with some mental tools or perspective? Thank you!!

OCD is a significant disorder that effects all aspects of life. If you think you suffer from this, seek professional help.

If you are, in fact, wasting time and supplies on things that are of no benefit to the patient, that is a problem. Your other patients will lose out while you are wasting time.

If, on the other hand, you are mis-using the term "OCD" to mean that you are contentious and thorough, that is a good thing, though a poor choice of wording. If the reality is that you are extremely detail oriented, and would prefer to do a limited number of tasks, but to do them perfectly, consider a field where this is an attribute. Surgery or ICU come to mind. Med surg or ER, not so much.

Which is it?

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337 Posts; 4,004 Profile Views

Maybe arming yourself with EBP and research data would reduce your OCD or maybe increase it. Here are 3 articles you may find interesting.

I tried the file upload, hopefully it works

third article won't load, here is the title you can find it on PUBMED etc.

Adequate Disinfection of a Split-Septum Needleless Intravascular Connector with a 5-Second Alcohol Scrub

Author(s): Mark E. Rupp MD, Stephanie Yu, Tomas Huerta, R. Jennifer Cavalieri RN,Roxanne Alter MS, Paul D. Fey PhD, Trevor Van Schooneveld MD and James R. AndersonPhD

Source: Infection Control and Hospital Epidemiology, Vol. 33, No. 7 (July 2012), pp. 661-665

Published by: Cambridge University Press on behalf of The Society for HealthcareEpidemiology of America

URL: Adequate Disinfection of a Split-Septum Needleless Intravascular Connector with a 5-Second Alcohol Scrub on JSTOR

Scrub the hub.pdf

Catheter hub disinfection.pdf

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amoLucia specializes in LTC.

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Perhaps get a peer to standby and watch your technique during some of your procedures. Ask for opinions on your performance.

Then take it from there.

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570 Posts; 6,931 Profile Views

I develop habitual actions for processes that I worry about. I study best practice and then decide on a series of actions. I do those actions in the same order, the same way, every time. Alternately there are actions I force myself to focus on. I will not speak, answer questions, think about my other patient, or anything else until I'm finished. I smile beforehand and say "just a minute. I need to focus, concentrate, etc." I've never had anyone object. Especially if I immeadiately focused on them after I finished.

Study best practice, print out organizational policies, and decide what works for you while adhering to both. Then stick to your process.

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Julius Seizure specializes in Pediatric Critical Care.

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Does your hospital have a policy regarding how long to scrub and allow the hubs to dry? Following that is going to be your best bet to combat infection. Instead of overthinking and making up what you think is safest.

I like this idea. Can you channel that vigilance into focusing on following policy/EBP carefully?

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Nurse SMS has 9 years experience as a MSN, RN and specializes in Critical Care; Cardiac; Professional Development.

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Sounds like advocating for Curos caps would be a good idea. :)

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