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Discussion

Scrub the hub

Wasnt everyone taught to scrub the hub for 15 seconds? My dad has a triple lumen central line that he gets weekly blood draws from and dressing changes from a local hospital. I have gone with him a few times and noticed that the nurses clean them at a MAXIMUM of 4 seconds. How do I handle this?

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  • Experts

It's 30 seconds, and let it dry for 30 seconds.

Where I work it is 30 seconds. And yes everyone learned that. There are a lot of things people know, yet still don't do. You might even do some of them yourself! It is hard being a patient and watching what happens. Frightening at times. Just think, your patients and their families are watching you and all your little details or time savers.

I didn't learn it, and no one I work with does it. I'm not saying your wrong, just that it's not standard here. Not in the policies either.

Of course we were taught that. I went to school in the 80's and back then we were required to swab a central line hub with betadine. I have noticed nurses who don't bother to swab anything, period. We were taught to swab the top of a bottle, even if you just plucked the top off of it, but I rarely see anyone else do this, either.

30 second scrub/30 second dry with chloraprep. 30 second scrub/15 second dry with alcohol. A minute each with betadine, although I'd imagine betadine for hub scrubs is silly unless there's a severe allergy. This is per my hospital's policies but I think this is industry wide. It's definitely more than 4 seconds! Say something the next time because it's all groovy till a nasty line infection pops up. Kinda makes me wonder about their dressing change technique, and infection rates.

I would speak up. I know it's another step to take, but I wouldn't let anyone not scrub mine if I were a patient. I'll pass on a nasty infection that could have been prevented by simply cleaning well. It's like eating without washing your hands.. YUCK!

Our policy is scrub for 15 seconds then let dry for 30 seconds. I have seen people connect without scrubbing. I make sure I have tons of alcohol swabs in my pocket so I can scrub the hub.

do they cap it off with the impregnated caps? Our hospital uses these caps and if you remove them and then connect you don't have to scrub...

While it's great if anyone is willing to scrub for 30 seconds and dry for 15-30 seconds, it's not the recommendation. Where the 30-second scrub idea came from is still sort of a mystery, as best we can tell it came from a CNS who made a poster advocating a 30 second scrub which then got shared on a CNS site and spread. The rationale was supposedly that if the rule was 30 seconds, then Nurses might scrub for at least 10-15 seconds.

The infusion nursing society, CDC, and HICPAC make no recommendations on scrub time. The closest thing to a recommendation from any of these groups is that Lynn Hadaway recommends a 15 second scrub and no dry time. Some manufacturers, such as Bard, have shown that effectiveness peaks with a 10 second scrub/5 second dry. The only comparative studies on the topic show a 5-10 second scrub to be no different than longer durations.

  • Experts

What Muno said AND it is facility policy driven.

Wasnt everyone taught to scrub the hub for 15 seconds? My dad has a triple lumen central line that he gets weekly blood draws from and dressing changes from a local hospital. I have gone with him a few times and noticed that the nurses clean them at a MAXIMUM of 4 seconds. How do I handle this?

Yes, it's 30 seconds, wait 30 to dry..however, I am in a Level III NICU and we have went as long as 1 1/2 years without a CLABSI and we just give it a good thorough scrub and go.

We do 15 sec scrub 30 second dry. Definitely say something!!!!!

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