Evidence Based Practice

Recall a situation when you were asked to perform a specific intervention and/or practice idea based on authority or tradition. Describe the intervention or practice. 

When I first finished nursing school, I worked as an RN on a medical-surgical unit. I was fairly new on the floor and being fresh off of orientation was absolutely terrifying. I had never flushed a PICC line on a real person before, and on that unit, we had to draw our own labs. One of my patients that required early morning labs had a PICC line in place. There was a nurse working with me that night, and I had asked her to come help me, or at least make sure I was doing things correctly as I never had done it live before. I flushed the line with saline first, wasted the required mL of blood, drew the actual blood in a new syringe, flushed with saline, and then with Heparin. This is also known as “SASH,” or saline, administer, saline, heparin. Each time a new syringe is attached to the PICC line, I was to clean the PICC line hub with an alcohol wipe for about 15 seconds. All of this is always performed with proper hand hygiene and gloves. Even though I was drawing blood, the process still held true. Everything worked out and I did the procedure correctly, however I was doing only what the nurse had told me to do and was unsure if that was the correct process or not.

Based on your knowledge of evidence-based practice, does this practice still hold value now?  Use an Evidence-Based Guideline or nursing specialty organization Standard of Practice to support your answer.

Based on my knowledge of evidence-based practice, the SASH method is still used. As a home care independent nurse, one of my patients has a power port, and SASH is used for that patient as well. Cleaning the hub of these central lines with an alcohol wipe for 15 seconds is also implemented every time. Expert opinion agrees with cleaning the hub with an alcohol wipe for about 10-15 seconds between each flush or medication administration (Hadaway, 2006). Infection prevention is one of the most important aspects of healthcare. There are so many germs and factors against an ill person, it is up to nurses and practitioners to prevent infection as much as possible. I am glad that when I accessed my first PICC line that I was able to perform things correctly, and I did not cause any harm or infection risk to my patient.

Hadaway, L. 2006. Flushing vascular access catheters: Risks for infection. Infection Control Resource, 4(2), 1-8.