ALERT: Do I remove the cap when cleaning a central line?
Connected Care Quick Hits are up to date and evidence based recommendations for the care of children with medical complexity & technology dependence, from hospital to home.
HINT: When a CVAD is used, always keep the cap connector on
SITUATION:
At a recent Connected Care CVAD workshop, home care nurses told us that they were removing CVAD caps to access a CVL line for blood work and/or to heparin lock the line. They shared that they didn’t know that syringes (including saline flush and heparin lock syringes) attach directly to the cap.
BACKGROUND:
When performing any procedure with a CVAD, it is important to follow the principles of aseptic non-touch technique (ANTT) to prevent contamination of key parts and key sites by microorganisms that could cause Central Line Associated Blood Stream Infections (CLABSI).
In ANTT, asepsis is ensured by identifying and then protecting key parts and key sites by hand hygiene, non-touch technique, using new sterilized equipment and/or cleaning existing key parts to a standard that renders them aseptic prior to use (Loveday et al, 2014; Rowley & Clare, 2011; Rowley et al 2010).
RECOMMENDATION:
When using the CVAD line (CVL, PICC, Port) for blood work or heparin locking, best practice is to keep the CVAD cap connector on in order to prevent CLABSI causing bacteria from being transferred from the surface of the line into the bloodstream. Keeping the cap on helps to maintain a closed system and protects a key site of portal of entry in preventing infection.
Remember to scrub the hub vigorously with an alcohol swab for 15 seconds and let it dry completely (another 15 seconds) before accessing the cap! The photo below shows the difference in bacteria under black light with different prep times.
If you’d like to book a virtual education session for you or your team, on recent updates to CVAD policies and practices, please be in touch!
Have a Question? Initiate a Consult!
