We often think of young people as rebels and their elders as better at following rules. But the opposite is true in American hospitals, a new study says – at least when it comes to disinfecting IV connectors.
Recent graduates of nursing school were more likely “to consistently use optimal disinfection techniques” than were more experienced nurses, according the study, in the May-June issue of the Journal of Infusion Nursing,.
The research examined whether younger or more experienced nurses adhered more closely to the “scrub-the-hub” manual method for disinfecting connectors. The method requires nurses to scrub the connector hubs with alcohol for up to 10-15 seconds and then wait up an additional 30 seconds for the alcohol to dry before accessing the line.
This protocol is widely recommended by infection control experts, but it must be performed meticulously to have any chance of being effective. The method’s several steps mean that variation is common, and busy nurses are known to sometimes skip disinfection altogether. The consequences of variation or noncompliance are great because incomplete disinfection increases the risk for sometimes deadly central line-associated bloodstream infections (CLABSIs).
The study found that nurses just out of school were more likely to perform the protocol exactly as it was taught – a good thing. The more experienced nurses, conversely, rated higher than younger nurses in such qualities as autonomy and “self-efficacy” (essentially, belief in one’s own competence). One can assume from this that more experienced nurses felt more free to stray from the protocol – not a great idea in this case and one that put patients in danger.
The findings may point toward one reason hospitals should be using a disinfection cap such as SwabCap® to supplement manual disinfection. SwabCap, from our client Excelsior Medical, is ingeniously designed to eliminate variation and noncompliance.
By prolonging the hub’s contact with alcohol, it may also increase the bacteria kill over manual methods, especially when compliance with the manual method is not optimal.
Considering what’s at stake, it seems to us that using the cap is a no-brainer – even if a nurse just graduated magna cum laude.
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