IP Dialysis practice question

[John Ferguson]

Wow! What a wonderful variation in practice you’ve documented.

In terms of rapidity of action, I would recommend an alcohol based preparation in general for disinfection – eg. 4% chlorhexidine in alcohol rather than betidine.

I do not know the specific evidence base for what to do in this specific situation.

I will post your question to the Aust Inf Control Association list serve and we may get some useful advice based on previous reviews/ evidence.

Regards
John

Dr John Ferguson
Director, Infection Prevention and Control Unit
Microbiologist and Infectious Diseases Physician
HUNTER NEW ENGLAND HEALTH
Locked Bag 1, Newcastle, NSW 2310, Australia
tel 61 2 49214422, fax 61 2 49214440
Visit http://www.hicsiganz.org for updates on healthcare infection prevention & control from around Australia and NZ.

>>> Amy Bertram 18/03/2010 10:45 am >>>
Hi John,
My name is Amy Bertram, I work out at the wansey dialysis unit. I was wondering if I could pick your brain??
I am on a national working party for peritoneal dialysis training guidelines.
We have come to the topic of what to teach patients if the mini-cap (lid with betadine inside it) comes of the catheter.
My question is how good is betadine at killing germs?? I did some bench marking around australia and found a huge difference in practices.
Out of 9 hospitals I phoned:
Seven of them do line change
Four give IP antibiotics (INCLUDING ONE WHICH GIVE THE AB’S ONLY IF THE CAP HAS BEEN OFF FOR A LONG TIME OTHERWISE JUST LINE CHANGE)
Two hospitals do not do line change for short period the cap has been off
one of them changes the minicap
the other one advises to do 2 rapid exchanges.
One hospital(outreach) gives a pack of 2 dicloxacillin tabs to all patients when they go home from training therefore they take this when minicap is off until they can get to the hospital for line change.
One hospital sends fluid sample for culture.
I believe our practice is great! just like every other unit! but need evidence..could you please guide me to where I could find information on betadine or how long it takes for germs to form in the peritoneal catheter…cavity??
Hope you can help
Thank you
Amy
Amy Bertram
Coordinator
Hunter Renal Resource Centre
Wansey Dialysis Unit
1A Dudley Road
CHARLESTOWN
NSW 2290
Ph +61 (2) 49048800
Fax +61 (2) 49048820

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