Course Access
Matthew
The original discussion is concerning port disinfection, and the same CDC HICPAC guidelines you refer to state:
‘Minimize contamination risk by scrubbing the access port with an appropriate antiseptic (chlorhexidine, povidone iodine, an iodophor, or 70% alcohol) and accessing the port only with sterile devices [189, 192, 194196]. Category IA’
Guidelines for the Prevention of Intravascular Catheter-Related Infections, 2011
http://www.cdc.gov/hicpac/pdf/guidelines/bsi-guidelines-2011.pdf
Cheers
Michael
Michael Wishart
Public Health Nurse,Communicable Disease Control
Logan West Moreton PHU
Ph 34131200 Fax 34131221
To contact Nursing team:
LWM_PHN@health.qld.gov.au
>>> “Richards, Matthew” 25/05/2012 8:30 am >>>
Tim
just a point of reference
The CDC 2011 guidelines recommendation for skin prep prior to the insertion of a CVC is “>0.5% CHG with alcohol….if there is a contraindication to CHG, tincture of iodine, an iodophor, or 70% alcohol can be used as an alternative”. The reality is 2% CHG in 70% alcohol is most commonly available and used.
The recommended CDC guidleiens for peripheral skin prep is with an antiseptic “70% alcohol….or alcoholic CHG gluconate solution”
regards
Matthew Richards
Clinical Nurse Consultant
Infection Prevention and Surveillance Service
Melbourne Health
T: 9342 8325 F: 9342 8484
http://info2.mh.org.au/IPSS/NewWEB/default.htm
From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Tim Spencer
Sent: Thursday, 24 May, 2012 4:39 PM
To: AICALIST@AICALIST.ORG.AU
Subject: Re: [ACIPC_Infexion_Connexion] cvc & other IV device bung/port cleaning protocol
Hi Jayne,
Currently, the CDC Guidelines, along with NICE (UK), SHEA (USA), INS (USA) and AVA (USA), ESPEN (Europe) and IVNNZ (New Zealand) all recommend 2% CHG with 70% IPA.
It’s is pretty much the worldwide standard for skin antisepsis prior to inserion of a IV device (peripheral or central), as well as hub/cap/valve decontamination on any IV device.
Never heard of it being injected into the patient! I would be interested to see your ID physicians supportive evidence to show any accidental injection of CHG & IPA into the patient and any detriments it may have.
The evidence speaks correctly. I would base your policy from “evidence-based research and practices’, not speculation from various individuals.
There is plenty of supportive literature.
Regards,
Tim..
Timothy R. Spencer, RN, APN, DipAppSci, Bach.Health, ICCert.
Clinical Nurse Consultant | Central Venous Access & Parenteral Nutrition Service
Conjoint Lecturer, University of NSW
Dept of Critical Care, Level 2, Clinical Building, Liverpool Hospital, Elizabeth Street, Liverpool, 2170, NSW, Australia
Tel 02 8738 3603 | Fax 02 8738 3551 | Mob 0409 463 428 | Tim.Spencer@sswahs.nsw.gov.au | Timothy.Spencer@unsw.edu.au
From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Jayne OConnor
Sent: Thursday, May 24, 2012 4:15 PM
To: AICALIST@AICALIST.ORG.AU
Subject: cvc & other IV device bung/port cleaning protocol
Dear All,
We are currently revising our CVC policy and just wondering what everyone used for cleaning the ports? All evidence points to 2% Chlorhexidine in 70% alcohol, but we have had conflicting advice from our ID physicians due to safety issues of injecting chlorhexidine into lines?
Look forward to responses.
Kind Regards
Jayne
Jayne O’Connor RN, BSc.in Infection Control
Clinical Nurse Consultant- Infection Prevention & Control
Sydney Adventist Hospital,
185 Fox Valley Rd,.
Wahroonga,
NSW 2076.
Tel: (02) 9487 9433
Mobile: 0406 752 685
Email: jayne.oconnor@sah.org.au
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