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Gina Ward
Do you use Chlorhexidine for picc line dressing changes


Hello there,

We have been using chlorhexidine for skin preparation for line insertion ever since the creation of our PICC team 5 years ago.  However, for the weekly or prn dressing changes we still use alcohol and betadine and then a chlorhexidine patch (biopatch). 

Recently the hospital changed the process for central line dressing changes to include the use of chlorhexidine instead of betadine and alcohol.  They made this change for the floor and icu staff and made it specific to Physician inserted and staff maintained lines;  juglar, ports and sublcavians etc... not the picc lines.  I didnt even know they made this change.  When I found out I felt like we need to make the same change to the process for our PICC line dressing changes as well.  ( I am the only person that does the piccs and I do al lthe dressing changes and maintence)  Seems like a double standard to me.   They said my infection rates were very low and didnt think I needed to change.  

My question is;   #1do you all utilize chlorhexidine upon insertion and then alcohol and betadine for rt dressings or use chlorhexidine for both.   #2  wouldnt these be having two different standards of care for central line dressings if they keep it different for a central line inserted and cared for by others than the PICC team? 

Thanks in advance,  Gina Ward R.N., C.P.A.N.




No recommendations for use of

No recommendations for use of CHG for insertion and care of CVCs make a difference in the type of catheter or the type of profesional who is inserting. The national standard of care for insertion and care of all these catheters is use of CHG. This is from CDC, IHI, INS, etc. In a legal case, I would use all of these documents and I would pay special attention to any differences such as what you describe. It would indicate to me, as the expert, that there was a different standard for one group of patients over the others and/or there was a specific reason for changing one and not the other. This would set up a situation where the plaintiff attorney tried to discover the basis for that difference. So lots of questions for management. At the very least, it would raise a lot of red flags for those experts reviewing the case, which would include all hospital policy and procedures. Hope this helps, Lynn

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

Lynn Hadaway Associates, Inc.

126 Main Street, PO Box 10

Milner, GA 30257


Office Phone 770-358-7861

Peter Marino
#2) Chlorhexidine for both.

#2) Chlorhexidine for both.

Peter Marino R.N. BSN CRNI VA-BC Hospital based staff R.N. with no affiliation to any product or health care company.

Barbara Tinsley
Chlorhexadine for both

Chlorhexadine for both

Barbara Tinsley

Mats Stromberg
We use chlorhexidine alcohol

for all CVAD dressing changes etc in Sweden and have since many years, at least 15 years. I have never used betadine, iodine etc since I became an RN in 1989. Since we started inserting PICCs in 1999/2000 in Sweden chlorhexidine alcohol has always been used for that as well. I don't think that Chloraprep or Biopatch are used much, at least I have never used them. Uncertain if they are CE marked (everything has to be CE marked to be used in Europe).


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