Scrub the Hub

[ManNurseBear]

So last night I was doing my standard shift routine and I was getting ready for blood draws. They all went well except on one blood draw I forgot to scrub the hub of the CVC before I accessed it. I didn't realize that I did it until I was more than half way done with all of my vials I needed. I felt so stupid because that is such a simple thing to forget and I feel really guilty... But, my question is, how probable is it that the patient will get sick?

[Dranger]

Dude chill, we have all done that. While it's not best practice I highly doubt THAT will be the reason your patient gets sick/more sick. I am guilty of doing IV pushes without scrubbing first especially during emergent situations.

[vintage_RN, BSN, RN]

I'd say the chances are slim, provided you used proper hand hygiene and sterility when accessing the device (aside from "scrubbing the hub" of course). There's nothing you can do about it now, just make sure to remember in the future ^_^

[blondy2061h, MSN, RN]

Dude chill, we have all done that. While it's not best practice I highly doubt THAT will be the reason your patient gets sick/more sick. I am guilty of doing IV pushes without scrubbing first especially during emergent situations.

I haven't ever done that. You can't risk that in BMT, especially not in a central line that goes directly into the heart. I strongly recommend you change your practice. Carry alcohol in your pocket. It takes seconds and can save another emergency if your patient goes septic. Every time one of my patients becomes bacteremic, I wonder if there's something I could have done to prevent it. Do you also skip washing your hands?

[CarryThatWeight, BSN]

I haven't ever done that. You can't risk that in BMT, especially not in a central line that goes directly into the heart. I strongly recommend you change your practice. Carry alcohol in your pocket. It takes seconds and can save another emergency if your patient goes septic. Every time one of my patients becomes bacteremic, I wonder if there's something I could have done to prevent it. Do you also skip washing your hands?

Wow, that's kind of harsh. The OP said they made a mistake and felt bad about it! No one is perfect. In the grand scheme of things, it IS unlikely to cause a major issue. And yes, I work oncology and BMT, so I do know it's best practice to scrub the hub. Of course. But we don't know what department OP works in and we all have seen ER and ICU nurses push without scrubbing. Most patients don't go septic from a tiny, isolated incident like that. I do think carrying alcohol swabs in your pocket is a good idea; it's what I do. A little grace for a colleague that made an error is in order, here.

[blondy2061h, MSN, RN]

Wow, that's kind of harsh. The OP said they made a mistake and felt bad about it! No one is perfect. In the grand scheme of things, it IS unlikely to cause a major issue. And yes, I work oncology and BMT, so I do know it's best practice to scrub the hub. Of course. But we don't know what department OP works in and we all have seen ER and ICU nurses push without scrubbing. Most patients don't go septic from a tiny, isolated incident like that. I do think carrying alcohol swabs in your pocket is a good idea; it's what I do. A little grace for a colleague that made an error is in order, here.

I was taking to the OP. I was talking to Dranger, who I quoted, who made it sound like he/she knowing skips if. I don't care where you work. You shouldn't be disregard key areas of practice. And yes, people can go septic from it. You don't know what the hub touched before you started pushing things through it. Again, not referring to the OP who did it once by accident.

[SubSippi]

I haven't ever done that. You can't risk that in BMT, especially not in a central line that goes directly into the heart. I strongly recommend you change your practice. Carry alcohol in your pocket. It takes seconds and can save another emergency if your patient goes septic. Every time one of my patients becomes bacteremic, I wonder if there's something I could have done to prevent it. Do you also skip washing your hands?

You probably have forgotten and didn't realize it.

[blondy2061h, MSN, RN]

You probably have forgotten and didn't realize it.

I highly doubt it. Anytime I go to access a lumen for any reason I grab the alcohol wipe at the same time and put it in my hand with the drug/tubes that need to be drawn. It's totally engrained in my habits. Again, not condemning the OP for forgetting once, but no one should just be disregarding the need to scrub the hub to save time. Not even ICU or ER nurses.

[elemenRN]

I highly doubt it. Anytime I go to access a lumen for any reason I grab the alcohol wipe at the same time and put it in my hand with the drug/tubes that need to be drawn. It's totally engrained in my habits. Again, not condemning the OP for forgetting once, but no one should just be disregarding the need to scrub the hub to save time. Not even ICU or ER nurses.

I agree... it's engrained in my habits, too. I can't stand it when people connect the tubing back onto itself instead of using a sterile cap either. However, in an emergent situation like the poster stated, I'm definitely going to push the epi and not waste 15 seconds scrubbing a hub.

[calivianya, BSN, RN]

I agree... it's engrained in my habits, too. I can't stand it when people connect the tubing back onto itself instead of using a sterile cap either. However, in an emergent situation like the poster stated, I'm definitely going to push the epi and not waste 15 seconds scrubbing a hub.

There are no sterile caps stocked where I work. I wish we had some of those. Which do you think is better - scrubbing the hub on the same line and connecting it back onto itself, or connecting it to a needle and leaving a needle free-floating in the air (in a cap, of course)? I have seen it done both ways at my facility, although connecting the tubing back on itself is much more common.

[blondy2061h, MSN, RN]

There are no sterile caps stocked where I work. I wish we had some of those. Which do you think is better - scrubbing the hub on the same line and connecting it back onto itself, or connecting it to a needle and leaving a needle free-floating in the air (in a cap, of course)? I have seen it done both ways at my facility, although connecting the tubing back on itself is much more common.

That stinks that there are no sterile caps. In that case, definitely connecting it back on itself.

[OCNRN63, RN]

I haven't ever done that. You can't risk that in BMT, especially not in a central line that goes directly into the heart. I strongly recommend you change your practice. Carry alcohol in your pocket. It takes seconds and can save another emergency if your patient goes septic. Every time one of my patients becomes bacteremic, I wonder if there's something I could have done to prevent it. Do you also skip washing your hands?

I find it hard to believe you have never, not once forgotten to scrub a hub. I think it's ridiculous to accuse someone of not washing his hands just because he's been honest and said, "Yeah, I've probably done that once or twice."

I worked in oncology, and I'm sure that I forgot to scrub a hub at least once. Go ahead and cast stones.