Forum topic

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

  I would also be VERY interested in this.

      Heather

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.

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

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 

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

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