Research is a necessary part of life for many health professionals especially when dealing with complex health issues for humans. The main goal for health professionals is to be able to provide safe and best practice care to those we care for regardless of sex, age, culture or religion.
One of the things I have noticed being a patient and a nurse is the different methods of practice that some health professionals use when providing care. Having said that it is important to point out that some health facilities have their own protocols, policies and guidelines regarding clinical care for their staff to follow, which relates to why some health professionals use different methods from others. This can be seen in some of the research around the practice of swabbing or not swabbing before giving injections.
One student nurse in New Zealand “Justine Grant” wrote an article for the Kai Tiaki New Zealand Nursing Journal (July 2007, Vol 13, No: 6) on her experiences of seeing some professional nurses not swabbing prior to injections, and other nurses swabbing. Even though this article was written in 2007 I feel it is still relevant today from my personal experience. As a patient I have had injections by various health professionals using alcohol wipes and others not using them which indicates a differing of practice when it comes to swabbing or not prior to injections.
Angela Cocoman and John Murray write an article from 2007 who state that from their research that if you swab before an injection the swabbing process should be 30 seconds on (swabbing with an alcohol wipe) and 30 seconds off to dry before injecting which I don’t think is practised by too many to that specific time schedule from my observation. Angela and John also mention that the World Health Organisation has recommended from research that swabbing before “intradermal, subcutaneous, and intramuscular needle injections” is no longer required. Ref: http://www.inmo.ie/tempDocs/IM_injections_Sep07.pdf
The “Journal of Liaquat University of Medical and Health Sciences” (JLUMHS) Jamshoro, in Pakistan from 2013 also did some research on the swabbing debate prior to injections. The conclusion from the authors Khawaja, R., Sikandar, R., Qureshi, R., Jareno, R., who researched the article in the (JLUMHS) concluded that…
‘routine skin preparation with alcohol swab before an injection is quite unnecessary and is of no significant value in safeguarding infection. Omitting skin cleaning with alcohol swab prior to an injection would save time and money’. Ref: http://www.lumhs.edu.pk/jlumhs/Vol12No02/pdfs/11.pdf
Just to be more advanced in the latest research out the Australian Immunisation Handbook 10th Edition 2013 also states;
“Provided the skin is visibly clean, there is no need to wipe it with an antiseptic (e.g. alcohol wipe). If the immunisation service provider decides to clean the skin, or if the skin is visibly not clean, alcohol and other disinfecting agents must be allowed to dry before vaccine injection (to prevent inactivation of live vaccines and to reduce the likelihood of irritation at the injection site)”. Ref: http://www.health.gov.au/internet/immunise/publishing.nsf/Content/handbook10-2-2
To conclude nurses need to evaluate their own practice and care and work within their employers guidelines regarding clinical protocols at their work place. As a student nurse in my final clinical placement I feel this small snippet of research into the swabbing or not swabbing has helped made my mind clearer on the topic. It also means that when I administer an injection I have that knowledge behind me just in case the topic arises with patients who are curious as to why I’m not about to swab before their injection. Of course if they insist they want me to swab I would be more than happy to oblige. I would also educate my patients that if I do swab I will do it as per research in 30 seconds on and 30 seconds off prior to administration of any injection.