swab stopcock before IV push?

[RNcathlab]

Do you always use an alcohol prep pad before giving an IV push medication? Has anyone ever heard the threory that using alcohol prep pads to clean a stopcock before giving IV push meds is not useful unless it sits for at least 3 minutes first and is allowed to dry? I have also heard that wiping with an alcohol prep pad and then immediately pushing meds can cause harm to the vein. I have worked with nurses in an ICU where 50% used alcohol prep and 50% did not when giving medications IV push.

[P_RN, ADN, RN]

I'll fall back on the old question: what does the policy manual say?

I realize that cath labs have different needs, but the general floors @ my place were not allowed to use stopcocks. There had been an incident earlier in our state where a pt exsanguinated when a stopcock was left in the wrong position.

And yes I would swab if the opportunity presented.

[TiffyRN, BSN, PhD]

I thought the waiting 3 minutes was for betadine, something about the active bacteria killing substances are only released as as the betadine dries; though we say to wait 1 minute after applying betadine. I have never heard that alcohol is only effective several minutes after it dries.

I feel there are exceptions to using alcohol. I watched a nurse (that I greatly respected) in the middle of a code, holding a syringe of some code med looking around asking; "Does anyone have an alcohol swab?". Yea, if someone is dead and needing epi, I think waiting for an alcohol swab is silly, use it if you have it, otherwise just give the med already. But for non-code drugs, the facilities I've worked for have always required alcohol wipe. In fact now that I work NICU we require a betadine application, wait 1 minute, then alcohol swab on any port to a line that is central (umbilical lines, CVL's, PICC's).

In the end it depends what your hospital policy is. If it states something like "administers IV meds in an aseptic technique" you have have trouble justifying not swabbing.

[SmilingBluEyes]

For giving IV meds YES, I always swab the stopcock first. And YES there are times when swabbing would not be your priority, like the above mentioned code situation.

[Tweety, BSN, RN]

If everyone swabs it keeps the site clean. Perhaps swabbing and immediately using it doesn't do much good, but it helps keep the site clean afterwards.

[Marie_LPN, RN, LPN, RN]

Always swab, unless it's a code, no time for swab.

[DusktilDawn]

Policy where I'm at is to swap ports prior to administering IVPs.

[Zee_RN, BSN, RN]

I always use alcohol prior to using a port on a peripheral or central line (unless impractical during a code). It is hospital policy, too.

[mitchsmom]

We've been swabbing at our clinical sites.

[Hoozdo, ADN]

I always use alcohol prior to using a port on a peripheral or central line (unless impractical during a code). It is hospital policy, too.

I have never heard of NOT swabbing, (unless it's a code).

[MarySunshine]

Another vote for the swabs.

[meownsmile, BSN, RN]

We use alcohol swabs,, however we have a anethsiologist that wants betadine used for the ports on a central line. He says alcohol doesnt really do any good,, but our policy calls for alcohol. So unless he specifically writes for betadine swab prior to using,, its alcohol.