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FW: cvc & other IV device bung/port cleaning protocol

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  • #69034
    Prue Wright
    Participant

    Author:
    Prue Wright

    Email:
    Infection.Control@HURSTVILLEPRIVATE.COM.AU

    Organisation:

    State:

    Hi Jayne,

    Recently there was a case when a woman was injected with clear
    chlorhexidine by error – she was having an epidural inserted .

    Because of this; it is preferred that prep for lines be dyed. This also
    has the advantage of being able to see what parts of the skin have been
    prepped.

    The ICU I used to work in used “lollipops”; so there could be no error.

    Regards

    Prue Wright

    Infection Control Co-ordinator

    Hurstville Private

    Behalf Of Tim Spencer

    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

    ________________________________

    Behalf Of Jayne OConnor

    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.

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    #69035
    Joeanne Bendall
    Participant

    Author:
    Joeanne Bendall

    Email:
    Joeanne.Bendall@SESIAHS.HEALTH.NSW.GOV.AU

    Organisation:

    State:

    That’s correct Jayne
    NSW Ministry of Health sent out a Safety Alert in September 2010 in response to this incident

    http://www.health.nsw.gov.au/quality/sabs/index.asp

    Thanks

    Joe

    Joe-anne Bendall
    Infection Prevention and Control CNC
    Sydney Hospital and Sydney Eye Hospital
    Macquarie St
    Sydney

    joeanne.bendall@sesiahs.health.nsw.gov.au

    Hi Jayne,

    Recently there was a case when a woman was injected with clear chlorhexidine by error – she was having an epidural inserted .

    Because of this; it is preferred that prep for lines be dyed. This also has the advantage of being able to see what parts of the skin have been prepped.

    The ICU I used to work in used “lollipops”; so there could be no error.

    Regards

    Prue Wright

    Infection Control Co-ordinator
    Hurstville Private

    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
    [cid:815383006@24052012-2F04][cid:815383006@24052012-2F0B]
    ________________________________
    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.

    If you are not the intended recipient you are hereby notified that any dissemination, distribution or reproduction of this message
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    #69039
    Tim Spencer
    Participant

    Author:
    Tim Spencer

    Email:
    Tim.Spencer@SSWAHS.NSW.GOV.AU

    Organisation:

    State:

    Yes, an unfortunate incident.
    And on that DOH Safety Alert, we changed ALL our CHG & IPA to red tinted
    solution.
    We also use the large and small lollipops.
    However, I think the swabs are still clear – not sure if they come in a
    tinted solution.
    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

    ________________________________

    Behalf Of Prue Wright

    Hi Jayne,

    Recently there was a case when a woman was injected with clear
    chlorhexidine by error – she was having an epidural inserted .

    Because of this; it is preferred that prep for lines be dyed. This also
    has the advantage of being able to see what parts of the skin have been
    prepped.

    The ICU I used to work in used “lollipops”; so there could be no error.

    Regards

    Prue Wright

    Infection Control Co-ordinator

    Hurstville Private

    Behalf Of Tim Spencer

    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

    ________________________________

    Behalf Of Jayne OConnor

    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.

    information intended for the addressee named above.
    If you are not the intended recipient you are hereby notified that any
    dissemination, distribution or reproduction of this message
    is prohibited. If you have received this message in error please notify
    the sender immediately, then destroy the original message.
    Any views expressed in this message are solely those of the individual
    sender, except where the sender is specifically authorised
    by Sydney Adventist Hospital to state that they are the views of Sydney
    Adventist Hospital.
    _____________________________________________________________________
    This e-mail has been scanned for viruses by Symantec Hosted Services
    Scanning Services – powered by MessageLabs. For further information
    visit http://www.messagelabs.com

    _____________________________________________________________________
    This email has been scanned for the Sydney & South Western Sydney Local
    Health Districts by the MessageLabs Email Security System.
    Sydney & South Western Sydney Local Health Districts regularly monitor
    email and attachments to ensure compliance with the NSW Ministry of
    Health’s Electronic Messaging Policy.
    Messages posted to this list are solely the opinion of the authors, and
    do not represent the opinion of ACIPC.

    Archive of all messages are available at http://aicalist.org.au/archives
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    Health Districts by the MessageLabs Email Security System.
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    Health’s Electronic Messaging Policy.
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