I work at a small rural hospital & I am trying to convince my nurse manager that we should use something other than alcohol wipes for IV site prep. I have been given the hint that the price of Chlorhexidine is prohibitive. At my previous work place we used B&D's Persist prior to switching over to Chlorhexidine. Am I correct in assuming the INS standard of care is Chlorhexidine? If so is Persist or a similar povo-iodine product an acceptable & more cost-effective alternative. If anyone has any literary references, I would greatly appreciate it.
Toby Knight-Meigs,RN,BSN,EMT-P,RRT
Staff Nurse in Western Oregon
According to the CDC guidelines, chlorhexidine gluconate is preferred but they do state that alcohol and povidone-iodine are acceptable. IHI also prefers chlorhexidine. INS has language similar to CDC - chlorhexidine preferred. Persist is a combo product of alcohol and povidone-iodine. Chloraprep and Chlorascrub are also combo products of chlorhexidine and alcohol. I am assuming you are talking about skin antisepsis prior to insertion of a short peripheral catheter. For insertion of all CVCs, there is a strong trend toward chlorhexidine based on published studies with better outcomes. With reimbursement for hospital acquired BSI going away in Oct 08, I think most hospitals are sticking to what works best. Lynn
Lynn Hadaway, M.Ed., RN, BC, CRNI
www.hadawayassociates.com
Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
Even the blood banks (www.aabb.org) are using chlorohexidine now before access for blood donation, and that IV only stays in 1 hour or less!
There are many articles showing the advantages of chlorohexidine over alcohol alone or alcohol and iodine.
MacMillan S.
Could you please comment regarding the use of iodine alcohol, 70% isopropyl alcohol and tincture of chlorohexidine in cleaning of silicone central venous catheter insertion sites and hubs.