Discussion in 'Professionally Qualified, RAMC and QARANC' started by badram, May 31, 2007.

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  1. Over the last two weeks I have had an injection and a blood test. On neither occasion was the area that had the needle put in it "swabbed" with the old alcohol wipe is this now normal. I always remember getting injections and having the area quickly wiped before the needle was inserted just something that has been bugging me.

    I am not medically trained and just wondering if it is no longer practice or a sloppy nurse.
  2. I know that you will get a long-winded technical reply from someone, but some studies show that the alcohol swabs take a fair while to work and may not be that effective....
  3. :mrgreen: As a person working in operating theatres doing this reguarly, and with strict guidelines to adhere to.... Call me old fashioned, but i think you are big enough to draw your own conclusions; without it having to be put in black and white for you. If you thought it was good practice you wouldn't have asked to start with !!! :giggle:
  4. On my psychiatric ward, we dont swab on visibly clean skin, thats our trust

    guidelines but trust policies vary, some swab some dont. why didnt you

    question it at the time?
  5. Erm.... was there an answer anywhere in there??? :p
  6. Pingle you are stating that it should be swabbed I think from your rather cryptic answer. Where as exarmybrat says it is down to trust guidelines, I did question it second time around but was told it was the afore mentioned guidelines, but not to happy with the answer.
  7. We're taught to swab the area, and leave it to dry for 30s or so. There's no point swabbing it then going straight in, it's the evaporation of the alcohol which kills bugs.
    A lot of people have the habit of swabbing it, then touching it again to be sure of where the vein is, so there's no point cleaning it in the first place, so if a trust thinks people don't do it properly therefore its a waste of money, that's maybe why it's not done.

    Best practice would be doing it, but doing it properly (I would think)
  8. They've taken away all the sterets in my Trust. Trust policy they say.

    So now I open a pack of sterile swabs and get some chlorhexidine to swab the skin before I stick anything into someone. This undoubtedly costs more in both time and money.

    The Trust's view will run like this: "Is there evidence that alcohol wipes prevent complications? No? Well then, why are we spending money on them?"

    My view is: "Does it do any harm? No. Could it potentially prevent a complication? Maybe. Does it reassure the patient that I am, as a surgeon, particular about cleanliness and sterility? Yes."

    The Trust can bugger off. This is a small issue, but I apply the principle to other areas where my assessment of best practice doesn't exactly match that of the bean-counters. I'm doing what I as a professional think is best for my doctor-patient relationship and, thankfully, the Trust have not had the temerity to tell me how to do that. Yet.


    P.S. - Don't worry though. I actually don't think a single prick with a sterile needle through your own skin is going be a problem - after all, you don't worry when you cut yourself shaving or get a splinter, and those implements aren't sterile.

  9. same here

    complete cannulation kits - all gucci.

    but a simple stereting of the skin takes a minute for the skin to become 'clinically clean'

    but any procedure that breaks the skin should be conducted with an aseptic technique
  10. the alcohol swab makes the skin more translucent and the vein more visible, wait for it to dry and you lose that.
    most people hit the skin with the steret and then get stuck in straight away.
    Theres never any sterets in my anaesthetic room as I squeeze them into my coffee. (my anaesthetic room! who am I kidding! :D )
  11. Friendly_Fire bang on, you are quite right it does give the impression that hygiene and cleanliness is in your mind and if the area is not swabbed it sows doubt in the mind of people like me.
    It is obvious though that there is a lot of differing procedures across the board I hope this is not a money saving exercise after all how much does a wipe cost compared to clearing up any potential infection.
  12. Dunking steretts in coke works a treat. :D