Share the article

Scrub the hub was introduced in the Unites States as a low-cost intervention to reduce central line-associated blood stream infections.

Each year 250,000 central line-associated blood stream infections occur in hospitals in the United States. Like all other health care-associated infections, central line-associated blood stream infections can lead to increased length and cost of hospital stay as well as increased risk for morbidity and mortality of patients. These negative impacts are worsened when the infection results from a multi-drug resistant bacteria.

“Scrub the hub” focuses on the preparation of the needleless adaptor. Studies found that using 70% alcohol solution or 2% chlorhexidine solution to clean the connector with friction for at least 15 seconds greatly reduced the occurrence of bacterial bloodstream infections.

5 steps for “Scrubbing the hub”:

  • Perform hand hygiene
  • Dont clean gloves prior to touching the line
  • Using alcohol and friction, scrub the needleless connector for 30-seconds in a twisting motion
  • Infuse medication or draw the blood and label as per the policy
  • Discard gloves and perform hand hygiene again

Genesis Health System created a fun video titled “Scrub the Hub Remix”. The video demonstrates the “Scrub the Hub” technique, explains its benefits and aims to motivate employees to use the method in their everyday work. The creation of the video itself is an excellent example of using creativity to engage others to help reduce the spread of antibiotic resistance. Their catchy-video can be seen here:

Selected Resources

Resource Description
An Android app for recording hand hygiene observation data The CleanHands mobile application for recording, transmitting and analyzing hand hygiene compliance data in health care environments. Available here for Android and here for iPhone.

More from "Examples from the field"

1.
Viswanath SK, Jie L, Meng QS, Yuen C, Tan TY. An Android app for recording hand hygiene observation data. Journal of Hospital Infection [Internet]. [cited 2015 Dec 14]; Available from: http://www.sciencedirect.com/science/article/pii/S0195670115003965
1.
Kime T, Mohsini K, Nwankwo MU, Turner B. Central line “attention” is their best prevention. Adv Neonatal Care [Internet]. 2011 Aug;11(4):242–8; quiz 249–50. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22123344
1.
Simmons S, Bryson C, Porter S. “Scrub the hub”: cleaning duration and reduction in bacterial load on central venous catheters. Crit Care Nurs Q [Internet]. 2011 Mar;34(1):31–5. Available from: http://www.ncbi.nlm.nih.gov/pubmed/21160298
1.
Sannoh S, Clones B, Munoz J, Montecalvo M, Parvez B. A multimodal approach to central venous catheter hub care can decrease catheter-related bloodstream infection. Am J Infect Control [Internet]. 2010 Aug;38(6):424–9. Available from: http://www.ncbi.nlm.nih.gov/pubmed/20137829
1.
National Healthcare Safety Network - NHSN. Central line insertion practices (CLIP) training course [Internet]. 2008 [cited 2014 Oct 22]. Available from: http://www.cdc.gov/nhsn/webcasts/CLIP/CLIPtrainingAug2008.pdf
1.
Scrub The Hub Remix [Internet]. 2013 [cited 2014 Oct 22]. Available from: https://www.youtube.com/watch?v=N9chcTqAitQ&feature=youtube_gdata_player
1.
Kaler W, Chinn R. Successful Disinfection of Needleless Access Ports: A Matter of Time and Friction. Journal of the Association for Vascular Access [Internet]. 2007 [cited 2014 Oct 22];12(3):140–2. Available from: http://linkinghub.elsevier.com/retrieve/pii/S1552885507703306