Question: Are you aware of the new dry time guidelines that pertain to using chlorahexidine? Does this apply to Central line dressing changes and peripheral blood cultures?
I just learned about this new website www.chlorhexidineFacts.com and am wondering if this is what you are referring to. I did not find any new instructions for drying time. This group is the product manufacturers of CHG devices, so their individual instructions for use would still be the standard of care. Also this website lists numerous other documents from multiple organizations that all are used to establish the standard of care. So please let us know if you are talking about something else. Lynn
It is my guess that these new guidelines are specifically related to the use of chloraprep in the OR since the alcohol is a fire hazard. I'm certain the reps could clear this up in relation to bedside picc insertions. Do we have any any on this list serve?
I learned about this change on Friday afternoon. I was also told that this only applied to one brand of CHG skin antiseptic at the present time. I have seen the label for this brand with these changes (thanks KK) and this would apply to all procedures where this product is being used, and not just the OR. I do not totally understand why the IFU has been changed. For CVAD/PICC insertion, I do not think this would slow down the procedure, although it may alter the procedure a little bit to accommodate this 3 minute drying time. After the skin prep, you could prepare the catheter and apply the drapes while this drying time is occurring. The problem that I see is using CHG for short peripheral insertions. I can foresee many hospitals going back to alcohol for this procedure. I can also foresee most not using multiple alcohol pads untill they come away looking clean. Alcohol is a great skin antiseptic agent, however we must either focus on a soap and water wash of the skin before insertion (which is what CDC and INS recommend if the skin is visibly dirty) or using multiple alcohol pads til they appear clean without visible change in color of the pad. I am concerned about what this could possibly do to the infection rates with short peripheral catheters. Lynn
I just checked the CareFusion website for Chloraprep. This statement is now found on all sizes of the Chloraprep products, even the small 0.67 mL size:
allow the solution to completely dry (minimum of 3 minutes on hairless skin; up to 1 hour in hair). Do not
You should probably contact each manufacturer to get their specific information. I did check the dry times for Chlorscrub and they are different from Chloraprep and different for PIV vs CVAD. Lynn
Our hospital is holding a meeting later today to discuss the ramifications of this change.
Our lead pharmacist found a lawsuit filed in NYS (2011) where a woman suffered burns from a fire in the OR. The circulating nurse stated the patient's surgical area had been clipped and prepped using Chloraprep. The nurse stated she saw "a hair" in the surgical field. Electrocaudery was used and the patient was receiving oxygen.
I'm surprised that more people have not responded to the original post as the new drying times pose a big problem to overall practice.
Wondering what those of you who use chloraprep have done since the longer dry times went in to affect??? did anyone switch products? if so...to what? 3 minute dry time in the ED, or in the units for that matter, for an IV start is never going to happen so if we continue with this product we will be out of compliance more often than not.
Please be more specific about what new guidelines you are referring to. Thanks 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
I just learned about this new website www.chlorhexidineFacts.com and am wondering if this is what you are referring to. I did not find any new instructions for drying time. This group is the product manufacturers of CHG devices, so their individual instructions for use would still be the standard of care. Also this website lists numerous other documents from multiple organizations that all are used to establish the standard of care. So please let us know if you are talking about something else. 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
I have heard this and need to confirm the change in labeling
30 second dry has changed to 3 minute dry. That is a significant difference and would be for all proceures is my guess
Dry with excessive hair is now one hour
Under two months there are some warnings now for chemical burns
Can anyone confirm these changes
Kathy Kokotis
It is my guess that these new guidelines are specifically related to the use of chloraprep in the OR since the alcohol is a fire hazard. I'm certain the reps could clear this up in relation to bedside picc insertions. Do we have any any on this list serve?
Darilyn
I learned about this change on Friday afternoon. I was also told that this only applied to one brand of CHG skin antiseptic at the present time. I have seen the label for this brand with these changes (thanks KK) and this would apply to all procedures where this product is being used, and not just the OR. I do not totally understand why the IFU has been changed. For CVAD/PICC insertion, I do not think this would slow down the procedure, although it may alter the procedure a little bit to accommodate this 3 minute drying time. After the skin prep, you could prepare the catheter and apply the drapes while this drying time is occurring. The problem that I see is using CHG for short peripheral insertions. I can foresee many hospitals going back to alcohol for this procedure. I can also foresee most not using multiple alcohol pads untill they come away looking clean. Alcohol is a great skin antiseptic agent, however we must either focus on a soap and water wash of the skin before insertion (which is what CDC and INS recommend if the skin is visibly dirty) or using multiple alcohol pads til they appear clean without visible change in color of the pad. I am concerned about what this could possibly do to the infection rates with short peripheral catheters. 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
I just checked the CareFusion website for Chloraprep. This statement is now found on all sizes of the Chloraprep products, even the small 0.67 mL size:
allow the solution to completely dry (minimum of 3 minutes on hairless skin; up to 1 hour in hair). Do not
blot or wipe away.
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
Is this only related to this one manufacturer? We use Chloraprep for central line insertions and Chlorascrub for peripheral IV insertions.
What about accessing chest ports? Often men are very hairy under the dressing where their port is located?
A 3 minute dry for an arm is reasonable. An hour for a hairy area is not. This needs more detail from the manufacturer.
You should probably contact each manufacturer to get their specific information. I did check the dry times for Chlorscrub and they are different from Chloraprep and different for PIV vs CVAD. 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
Our hospital is holding a meeting later today to discuss the ramifications of this change.
Our lead pharmacist found a lawsuit filed in NYS (2011) where a woman suffered burns from a fire in the OR. The circulating nurse stated the patient's surgical area had been clipped and prepped using Chloraprep. The nurse stated she saw "a hair" in the surgical field. Electrocaudery was used and the patient was receiving oxygen.
I'm surprised that more people have not responded to the original post as the new drying times pose a big problem to overall practice.
Wondering what those of you who use chloraprep have done since the longer dry times went in to affect??? did anyone switch products? if so...to what? 3 minute dry time in the ED, or in the units for that matter, for an IV start is never going to happen so if we continue with this product we will be out of compliance more often than not.