CDC recommendations for 2017 included an updated recommendation for
"Chlorhexidine-impregnated dressings with an FDA-cleared label that specifies a clinical indication for reducing catheter-related bloodstream infection (CRBSI) or catheter-associated blood stream infection (CABSI) are recommended to protect the insertion site of short-term, nontunneled central venous catheters"
Our hospital has been using CHG sponges (Biopatch) for quite some time. Do the new recommendations mean we need to switch to a CHG dressing (ie Tegaderm) or will the sponge still meet these recommendations?
The CHG foam dressing was the original device with the required FDA labeled indication. So no product switching should be necessary
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
Hi Lynn,
Could you provide your thoughts on the site inspection with both of these antimicrobial dressing and sponge? Biopatch claims on their manufacturer chart that the insertion site can be visualized. I am not clear what they are referring to? I guess my question is how can we thoroughly assess the site if unable to see it under the sponge disk or does it really matter? We have been using it for years and just assumed it is providing the protection required to prevent extraluminal line infections. I have not been able to find any evidence that provides me a good answer to why it would NOT be necessary to clearly assess the insertion site.
Thank you if you could provide some insight I would really appreciate it.
Your assessment should include the entire system from fluid container down to VAD and dressing. Assess dressing for being adherent, dry, and clean and gently palpate the area for any change in skin temp, or patient discomfort. You will not be able to directly see the puncture site with either the CHG pad or gel. But you are not going to see signs of BSI at the insertion site. Carefully inspect the actual puncture site at each dressing change. If there are problems found, take action then. You cannot see the site if using gauze and tape either. See INS SOP VAD Assessment, Care and Dressing Changes. Remember, the CDC statement is talking about CRBSI, not just CLABSI. Big difference.
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
Thank you Lynn