We have all heard of the Five Second Rule. The rule is that if food falls on the ground, it may be safely eaten as long as it is picked up within 5 seconds.

There have been several studies about the Five Second Rule, to prove or dispel the myth. A study done at Clemson University found that over 99% of bacterial cells were transferred from a contaminated tile to a piece of bologna after only 5 seconds of exposure to the tile. The study went on to state that Salmonella Typhimurium can survive for up to 4 weeks on dry surfaces in high-enough populations to be transferred to foods and S. Typhimurium can be transferred to the foods tested almost immediately on contact.

So what does the Five Second Rule have to do with IV therapy?

There is an alarming trend occurring nation wide. Clinicians are not cleaning injection ports before using them. If food contamination occurs in 5 seconds or less, what is on those injection ports that have been lying on blankets, dragged across floors, brushed over sinks, and skimmed across toilets between uses? When the ports are not properly cleaned bacteria are flushed directly into the patient’s veins.

There are many national IV organizations that clearly state the need to clean injection ports before use.

The Infusion Nurses Society standard of practice states "To prevent the entry of microorganisms into the vascular system, the injection or access port should be aseptically cleansed with an approved antiseptic solution immediately prior to use; antiseptic solution containers in a single-use package should be used."

The CDC recommendation states: For needleless intravascular devices "minimize contamination risk by wiping the access port with an appropriate antiseptic and accessing the port only with sterile devices." It also states that for IV-injection ports "Clean injection ports with 70% alcohol or an iodophor before accessing the system."

The Association for Vascular Access has a national initiative called SAVE That Line. The V stands for Vigorous friction to hubs with alcohol whenever you "make or break a connection."

There is no specific standard that states the exact solution to use, the amount of time to scrub, or the length of time to let the solution dry before access.

Marcia Ryder PhD, MS, RN has been doing a study for the last two years addressing all of these questions. She has also been testing a new disinfection device. Marcia presented her information in March at the Society for Healthcare Epidemiology of America (SHEA) conference. Keep your eyes open for this exciting new development.

In the meantime always keep patient safety in mind, including IV safety. Implement a new Five Second Rule into your practice, when you need to access an IV line. Take 2 seconds to think about where the IV has been, 2 seconds to think about what germs could be injected into the patient’s vein and 1 second to pick up a disinfecting swab to start cleaning.