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TerryF
Chlorhexidine Gluconate wipes prior to PICC insertion

I would like to know how many Vascular Access Teams are currently washing the patient arm and possibly chest, and/or axillary area with Chlorhexidine Gluconate (CHG) prior to insertion. If so; do you do this for all patients or just the know MRSA, C-diff, VRE patients?

I have an article from AACN recommending this for routine bathing in the ICU. http://www.aacn.org/docs/cemedia/C1453.pdf CriticalCareNurse Vol 34, No. 5, OCTOBER 2014 17

The AACN article states that CHG bathing alone specifically reduces the risk of CRBSI. It also referenced several articles (4, 23-26).
Does anyone have any other or newer evidence based literature concerning this practice for PICC insertion?

Thank you for your time,
Terry

Jessica Newsom
CHG wipes

Do you mean washing the arm w/ CHG prior to and in addition to scrubbing the arm for the procedure?
Jessica

Jessica Newsom

lynncrni
 Routine daily bathing with

 Routine daily bathing with CHG is recommended especially for ICU patients with a CVAD. it has been shown to reduce CLABSI. But that is not the same thing or even applicable to the CVAD insertion procedure. The standard for insertion of all VADs - peripheral and central - is to begin with clean skin. This means a physical soap and water wash when the skin is visibly dirty then applying the CHG skin antisepsis. I am not aware of any recommendations supporting using CHG bathing in the arm/chest area prior to insertion. The goal is to physically remove dried blood, skin oils, sweat, and other dirt because simply applying skin antiseptic to these skin conditions is not adequate and regular soap and water is sufficient. Lynn

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

Lynn Hadaway Associates, Inc.

126 Main Street, PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

TerryF
Thank you for your response.

Thank you for your response. I have seen Vascular Access Teams doing this prior to insertion. We are implementing the 2% CHG bath in the ICU.

Gina Ward
Our ICU does the chg baths,..

Our ICU does the chg baths,....when we put in a line we are doing the chg prep only to the planned insertion site, or rather the entire exposed area of the upper arm we have selected.

Gina Ward R.N., VA-BC

mkcrowe01
 We started bathing the

 We started bathing the patient's procedure arm prior to start of procedure - we felt that many of our intpatients were not getting adequate hygiene and this way we could knowingly start with clean skin. We use either CHG wipes or no-rinse soap wipes based on the patient unit - critical care & patients from another facility get CHG wipes. This is per our IP in response to an event. ICU performs CHG bathing daily. 

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