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schmich
Chlorahexedine to clean hubs?

Has anyone seen any evidence that suggests using chlorhexedine rather than alcohol to clean/swab injection ports/hubs? This was suggested at a meeting this morning, but I haven't been able to find any literature that even addresses the issue. Anyone able to help?

lynncrni
I think Marcia Ryder is
I think Marcia Ryder is working on something but I have not seen anything published yet. I may have missed it though, so eager to know if someone else has seen something. It has only been within the past 12 to 15 months that we have had a chlorhexidine-impregnated flat pad to clean this surface. Alcohol pads and manual friction before each entry is still the recommended method for cleaning. Lynn

Lynn Hadaway, M.Ed., NPD-BC, CRNI

Lynn Hadaway Associates, Inc.

PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

Gwen Irwin
In the fall issue of JAVA,

In the fall issue of JAVA, the study about the microbial transfer via caps indicated that it didn't matter which cap or which cleaning agent (alcohol, iodofor, or chlorhexidine) was used, but that it was the time (15 seconds) and friction that decreased the microbes transferred through the cap most significantly.

Am I saying this right?

Gwen Irwin

Austin, Texas

 

Heather Nichols
  I would also be VERY

  I would also be VERY interested in this.

      Heather

Chonna L. Barth...
The basics are helpful for

The basics are helpful for the bedside nurses 

Disinfection is dependent upon solution, friction, time and drying. 

Alcohol evaporates fastest and is great for ports, but the surface must be flat in order to accomplish a friction scrub.  Chlorhexidine on the otherhand is more effective for skin, betadine in cases of fungal infections etc.

    

Peggy McDaniel
The article was published in

The article was published in JAVA, Sept. 2007 - by Kaler and Chinn.  They were able to show, independent of the design of the connectors tested, that a 15 second scrub with EITHER alcohol or CHG were equally effective at preventing the transfer of bacteria through the devices (100% effective).  This is the first data published since Maki's article related to his CHG cap which showed that a 2-3 second scrub with alcohol was not 100% effective in preventing transmission.  Both of these studies are lab studies and it's great information.

Happy New Year!

Peggy McDaniel RN BSN

Infusion Practice Manager, Western Region

Cardinal Health

Peggy McDaniel RN BSN

Infusion Practice Manager, Western Region

CareFusion

janetpettit
The CIUC at Children's

The CIUC at Children's Healthcare in Atlanta compared 3.15%CHG to alcohol for hub cleaning and found a lower rate of CRBSI in the CHG group.  They had a poster at AVA in Phoenix.

 

Janet Pettit 

Monica Preston
Is anyone interested in

Is anyone interested in sharing statistical information about an IV Team that they may be working on?

1. What size team do you work on?

2.Number of staff  RNs/LPNs

3. Number of PICC insertions/quarter

Do you do IJ PICC insertions?

4.Number of peripheral IV insertions/quarter

5.Salary

6. Number of other central lines/quarter cared for?

 

Thanks

 

 

Daphne Broadhurst
I just came across another

I just came across another article which discusses this. The following is an excerpt from:
Casey, Anna L; Elliott, Tom SJ.  Infection risks associated with needleless intravenous access devices. Nursing Standard. 22(11):38-44, November 21, 2007

"Recent UK guidelines recommend that a single patient use application of alcohol/chlorhexidine gluconate solution (preferably 2% chlorhexidine gluconate in 70% isopropyl alcohol) should be applied to decontaminate injection ports and needlefree devices before and after use (Pratt et al 2007). If alcohol/chlorhexidine gluconate use is contraindicated by the manufacturerer of the device, either aqueous chlorhexidine gluconate or aqueous povidone-iodine should be used (Pratt et al 2007)....During an evaluation of a needleless IV access device, the efficacy of 70% (v/v)isopropyl alcohol, 0.5% (w/v) chlorhexidine gluconate in 70% (v/v) isopropyl alcohol, and 10% (w/v)  aqueous povidone-iodine for the disinfection of the external compression seals of the needless IV access devices was assessed (Casey et al 2003). Application of either the chlorhexidine or povidone-iodine solutions significantly reduced contamination of the external silicone compresssion seal of the needleless device compared to isopropyl alcohol (Casey et al 2003).

Cheers,

Daphne Broadhurst, RN
Ottawa ON

Daphne Broadhurst
Desjardins Pharmacy
Ottawa, Canada

lynncrni
The published experience

The published experience with needleless connectors in the UK is very different from the US. In the UK, they routinely place a stopcock on the end of a catheter hub, then put the needleless connector on the stopcock. They have several publications showing no increased risk of infection and Dr. Elliott is a leading investigator. I heard him give a presentation on the data in this article last August. I ask him how we could generalize their work to our practice since there were differences with the stopcocks. He really did not have an answer but praised our efforts to rid our practices of stopcock use because they are known to increase the risk of infection. Any UK nurses reading this that can give us more information on the differences in our practices with needleless connectors?  

 

Lynn Hadaway, M.Ed., RN, BC, CRNI

www.hadawayassociates.com

Lynn Hadaway, M.Ed., NPD-BC, CRNI

Lynn Hadaway Associates, Inc.

PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

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