Doctors and
nurses are not thought about hand washing and so are unaware of what
effect this can have on patients. To be effective, hands should be
rubbed together vigorously with soap and warm water for at least 15
seconds. Brief rubbing or simply rinsing under running water is not
enough. Bacteria are stuck in oils that adhere to the skin.
Agitation by rubbing loosens the dead skin cells, and soap keeps the
contaminants and germs suspended in the water so they rinse off. Soap
does not kill the bacteria. In fact, germicidal soaps must remain in
contact with the skin for several minutes to kill germs.
Anti-bacterial
soaps may give a false sense of security that could lead to less
vigorous washing. Hand Washing Week in USA Dec
2007
highlighted the importance of preventing spreading infections. Widely used antibacterial soaps is said
contribute to the development of antibiotic resistant bacteria. The
antibacterial agents produce a genetic change in bacteria which enables
them to become more drug-resistant (Nature 394:531-532, 199).
Healthcare
professionals who introduce cannula, catheters must use proper hand and
skin cleaning procedure, reduce number of attempts, adhering to aseptic
technique to avoid contamination. Skin cleaning is often incomplete,
and many attendants still palpate with non-sterile gloves the
vein-puncture site before needle insertion. Accidentally introduced
micro-organisms grow to pathological levels and result in bacteraemia in
48 hours.
Guidelines about aseptic
techniques for cannula insertion are described in the US Centers
for Disease Control (CDC) guidelines
(2002). These guidelines were developed for practitioners who insert
central venous catheters (CVC) in intensive care settings and were not
based on peripheral venous cannula (PVC). Published guidelines on hand
hygiene in health care in their website will soon need updating based on
the present available information. Medical journals claiming 73% of
healthy adults visiting hand surgeons carried CA-MRSA in their hands,
JAMA reported 57% of healthy adults are colonized with invasive MRSA.
Short peripheral cannula is usually inserted in the veins of the forearm
or hand is likely to help bacterial inoculation resulting in death. .
Sterile gloves must be used for appropriate aseptic
technique; however, the CDC recommends the use of a new pair of
disposable non-sterile gloves and a no-touch technique during the
insertion of peripheral venous cannula or during blood test. Use of
gloves as a standard precaution is for the prevention of exposure to
blood borne pathogens (CDC, 2002) to healthcare workers. This does not
prevent patients getting infection. We advice you to please use sterile
glove in the interest of patients.
Make sure
the skin is cleaned properly and left in place for 1-2 minutes. The
doctors or nurse must not touch the area repeatedly with their finger
after they introduce the needle tip through the skin. Demand straight
non-ported cannula for your safety
Skin
Preparation before Injecting Needle through Skin
Firmly swipe skin of patient using a fresh swab or soap and
water in circular fashion as shown in the diagram (please start
in the centre and always move outwards)
Never go over the centre point after you clean
the peripheral area.
Please repeat this process 2-3 times using
fresh new swab.
Use the centre point to inject needle or
insert cannula
Further Reading
Using Detergents may increase infections & facilitate bacteria
developing resistance
