Hand hygiene and needleless connector decontamination for peripheral intravenous catheter care—time and motion observational study

Published:March 05, 2019DOI:


      • Of nurses, 99% “scrubbed the hub” of the needleless connector.
      • Of nurses, 3.7% were compliant with a 15-second needleless connector “scrub.”
      • Hand hygiene premedication preparation was 33%.
      • Hand hygiene postmedication administration was 65%.
      • Poorest hand hygiene rates observed in the ED and those wearing gloves.
      Good hand hygiene and “scrub the hub” practices are important to prevent bloodstream infections. This observational study (n = 108) found high compliance with “scrubbing the hub,” although scrub time was shorter than the recommended duration (average 6.1 seconds). Compliance with hand hygiene before medication preparation (33%) and before medication administration (43%) showed room for improvement compared with postadministration (65%), the emergency setting and glove use were associated with poorer compliance (P < .01).

      Key Words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to American Journal of Infection Control
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Pujol M
        • Hornero A
        • Saballs M
        • Argerich M
        • Verdaguer R
        • Cisnal M
        • et al.
        Clinical epidemiology and outcomes of peripheral venous catheter-related bloodstream infections at a university-affiliated hospital.
        J Hosp Infect. 2007; 67: 22-29
        • Stango C
        • Runyan D
        • Stern J
        • Macri I
        • Vacca M
        A successful approach to reducing bloodstream infections based on a disinfection device for intravenous needleless connector hubs.
        J Infus Nurs. 2014; 37: 461-463
        • Stuart R
        • Cameron D
        • Scott C
        • Kotsanas D
        • Grayson ML
        • Korman T
        • et al.
        Peripheral intravenous catheter-associated Staphylococcus aureus bacteraemia: more than 5 years of prospective data from two tertiary health services.
        Med J Aust. 2013; 198: 551-553
        • Aziz A
        Variations in aseptic technique and implications for infection control.
        Br J Nurs. 2009; 18: 26-31
        • O'Grady N
        • Alexander M
        • Burns L
        • Dellinger E
        • Garland J
        • Heard S
        • et al.
        Summary of recommendations: guidelines for the prevention of intravascular catheter-related infections.
        Clin Infect Dis. 2011; 52: 1087-1099
        • Moureau N
        • Dawson R
        Keeping needleless connectors clean, part 1.
        Nursing. 2010; 40: 18-19
        • Hadaway L
        Needleless connectors: improving practice, reducing risks.
        JAVA. 2011; 16: 20-33
        • Moureau N
        • Dawson R
        Guide to patient safety, needleless connector know-how.
        Nurs Manag. 2010; 41: 40-41
        • Menyhay S
        • Maki D
        Disinfection of needleless catheter connectors and access ports with alcohol may not prevent microbial entry: the promise of a novel antiseptic-barrier cap.
        Infect Control Hosp Epidemiol. 2006; 27: 23-27
        • Erasmus V
        • Daha T
        • Brug H
        • Richardus J
        • Behrendt M
        • Vos M
        • et al.
        Systematic review of studies on compliance with hand hygiene guidelines in hospital care.
        Infect Control Hosp Epidemiol. 2010; 31: 283-294