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Gina Ward
Marcia Ryder double skin prepping technique

 

I recently attended our FLAVAN meeting in Orlando.  I was very pleased with the event and speakers and the information recieved.  I meant to ask Marcia Ryder a question and did not get the chance.  I think I may have heard someone hint on the answer there so I will post it.

 

I heard some mention of a double skin prepping prior to  PICC lines;   some kind of arm cleansing then a sterile wrap and then routine prepping????  or maybe just pre cleansing with soap and water and then our routine prep. 

 

I have done a literature search and cant seem to find it.  I find articles of hers but not specific to that process.

 

Thank you in advance,  Gina Ward R.N.

lynncrni
 Both CDC and INS documents

 Both CDC and INS documents refer to starting with clean skin. If the skin is visibly dirty, it must be washed with soap and water prior to the application of skin antiseptic. I am not sure what Marcia was referring to unless it was this skin wash prior to applying the antiseptic. You will find these statements in both documents. Lynn

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

Robbin George
Gina--Just search the words

Gina--Just search the words "Sage Cloth" on this web site--You participated in a conversation about pre procedure CHG bathing prior to PICC insertion

Robbin George RN VA-BC

Gina Ward
Thank you both.   Robin I 

Thank you both.   Robin I  had some additional questions I posted and didn't get answered so I felt I didnt have the full info.   I re read your response though.

 

I  have some technical/procedural questions on that process.    

 

1.  The wipes used to pre clean the arm are they sterile?  or just clean and we use them to do a good cleansing ahead of time and wrap in sterile drape to prevent further

contamination.

 

2.  Are you applying the sterile drape in a sterile manner , or just keeping it un touched on the inside where the patients arm is touching it ( and then laying it back on the bedside table you keep the arm on) .  I imagine this is an effort to keep the skin as clean as possible after the cleansing.

 

3 . then when you are lifting up the  arm that is wrapped in the "sterile towel" are you lifting that up with clean gloves to place on top of your bottom drape, just as if it were a regular arm and moving it to locate it on the drape.  then, open sterile towel and then begin the process of prepping with the chg included in the kit and proceeding as usual from there.

 

thank you so much for your response!!   you can respond here or email me directly at [email protected] if you chose.   Sorry for the many question, but.....If I am going to do this I want to do it right from the start . 

Gina Ward R.N., VA-BC

Gina Ward
Thank you both.   Robin I 

Thank you both.   Robin I  had some additional questions I posted and didn't get answered so I felt I didnt have the full info.   I re read your response though.

 

I  have some technical/procedural questions on that process.    

 

1.  The wipes used to pre clean the arm are they sterile?  or just clean and we use them to do a good cleansing ahead of time and wrap in sterile drape to prevent further

contamination.

 

2.  Are you applying the sterile drape in a sterile manner , or just keeping it un touched on the inside where the patients arm is touching it ( and then laying it back on the bedside table you keep the arm on) .  I imagine this is an effort to keep the skin as clean as possible after the cleansing.

 

3 . then when you are lifting up the  arm that is wrapped in the "sterile towel" are you lifting that up with clean gloves to place on top of your bottom drape, just as if it were a regular arm and moving it to locate it on the drape.  then, open sterile towel and then begin the process of prepping with the chg included in the kit and proceeding as usual from there.

 

thank you so much for your response!!   you can respond here or email me directly at [email protected] if you chose.   Sorry for the many question, but.....If I am going to do this I want to do it right from the start . 

Gina Ward R.N., VA-BC

lynncrni
 CHG bathing cloths are not

 CHG bathing cloths are not sterile and can not be used to replace the application of a skin antiseptic. They could be used to wash the arm before apply CHG skin antiseptic in a back and forth scrubbing motion, but not to replace it. I hope I am misunderstanding this part of the discussion and no one is actually trying to do that. Bathing the entire patient with these CHG cloths has been shown to reduce infections and are a good think, just not to repalce the regular skin antiseptic agent and procedure. Lynn

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

Gina Ward
  I always took and

 

I always took and understood it to be just a "pre cleansing" before the actual prepping process of the arm with our chg/alchol.   I was just wondering the exact steps

of this "pre cleansing" and was asking for specifics since they mentioned applying a sterile drape to the site after they precleaned it.

 

Thanks so much Lynn for your concern you are an assett to all of us with your wealth of information and clarity. 

Gina Ward R.N.

Gina Ward R.N., VA-BC

lynncrni
 I am wondering if this

 I am wondering if this precleaning required the additional drape because it was separated in time from the actual skin antisepsis. I have never seen a procedure using this drape. Let us know if you find one. Lynn

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

Robbin George
We wash the entire arm--from

We wash the entire arm--from shoulder to forearm--back and front including the armpit--This is designed as a pre procedure bath to decrease the bio load in the anticipated area of PICC insertion

Application and removal of the sterile drape is not part of the actual sterile procedure of PICC insertion--We only wrap the arm to preserve the pre procedure cleansing

Robbin George RN VA-BC

Gina Ward
Great,  Thanks so much! 

Great,  Thanks so much!  Gina

 

Gina Ward R.N., VA-BC

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