Re: skin prep for haemodyalisis

[Ryan, Lindy]

Thanks Carolyn

We are already doing all you have suggested ..unfortunately, we seem to have one of the rare pts who is highly sensitive to everything suggested within the guidelines you have outlined in your response (hence only being able to use sterile N/Saline )
I was just wondering if there was anything else anyone could suggest or had experience with re this rare pt group re dialysis access for fistulas as I am unable to fnd anything further in the literature I have searched

Thank you for taking the time to respond

Kind regards

Lindy

Lindy Ryan

Infection prevention & Control Clinical Nurse Consultant (CNC) | Coffs Harbour Health Campus
Pacific Hwy Coffs Harbour NSW 2450
Tel (02) 6656 7770 | lindy.ryan@ncahs.health.nsw.gov.au
http://www.health.nsw.gov.au

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Wise and humane management of the patient is the best safeguard against infection
(Florence Nightingale Circa 1860)

From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Carolyn.Chenoweth@FMC-ASIA.COM
Sent: Friday, 9 December 2016 10:00 AM
To: AICALIST@AICALIST.ORG.AU
Subject: Re: skin prep for haemodyalisis – question

Hi Lindy,
See below for haemodialysis access cleansing that we recommend for patients in our dialysis clinics across Australia and Asia Pacific.

1. Educate patients to wash their fistula with normal liquid hand soap (we do not use antimicrobial hand soap) at dedicated clinical hand basins (no liquids e.g. dialysate emptied into these sinks) on arrival.
If patients have mobility issues and can’t access the clinical hand basins we offer alcohol based hand rubs to clean their hands and fistula.

2. We recommend Chlorhexidine (0.5% to 2%) combined with alcohol, swabs for all skin cleansing prior to cannulation.
2% chlorhexidine can cause skin irritation while rarely have issues with 0.5% or 1%chlorhexidine and alcohol.
If chlorhexidine can’t be tolerated at all we either use povidine iodine or plain alcohol swabs.
The very rare patients who are highly sensitive to everything we just ensure very good hand washing and washing fistula with liquid hand soap.

With best regards
Carolyn Chenoweth
Quality & Infection Prevention and Control Manager, Australia
Asia Pacific Quality & IPC SME. CICP

Fresenius Medical Care Australia Pty Ltd
Payneham Dialysis Clinic,
2 Portrush Road
PAYNEHAM 5070
Australia
T: +61 (0) 8 8165 4313
M: +61 (0) 407 810 800
http://www.fmc-ag.com

From: “EXTERN ACIPC Infexion Connexion” <AICALIST@AICALIST.ORG.AU>
To: AICALIST@AICALIST.ORG.AU
Date: 09/12/2016 07:59 AM
Subject: skin prep for haemodyalisis – question
________________________________

Hello

We have a pt with sensitivity to povidine /iodine and CHG who has a fistula & is having regular haemodialysis .

Other than cleaning her skin with sterile normal saline prior to cannulating them for their dialysis is there any other skin antisepsis that could be used.

I have looked at referenced from CDC and APIC but there is nothing useful re any other skin antisepsis just wondering if anyone out there was using anything else in these pts with success or is sterile normal saline the only best option to stick with ?

Many thanks

Kind regards

Lindy

Lindy Ryan

Infection prevention & Control Clinical Nurse Consultant (CNC) | Coffs Harbour Health Campus
Pacific Hwy Coffs Harbour NSW 2450
Tel (02) 6656 7770 | lindy.ryan@ncahs.health.nsw.gov.au
http://www.health.nsw.gov.au

Wise and humane management of the patient is the best safeguard against infection
(Florence Nightingale Circa 1860)

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This message is intended for the addressee(s) named and may contain confidential information. If you are not the intended recipient, please delete the message and any attachments and notify the sender. Views expressed in this message are those of the individual sender, and are not necessarily the views of NSW Health or any of its entities.

MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.

The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.

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