Scrub the hub advice – Non-sterile swabs versus sterile swabs

[Meyer-Henry, Simon]

Hello everyone,
With regard to scrubbing the hub for active disinfection of peripheral IV cannulas and central lines; I’d like some advice or opinions on whether or not sterile 70% isopropyl alcohol skin cleansing swabs are preferable to non-sterile 2% chlorhexidine & 70% isopropyl alcohol skin cleansing swabs.

The use of 2% chlorhexidine and 70% alcohol for hub disinfection is commonly referenced in the literature and best practice guidelines, however, usually without mention of any requirement for sterility of the solution. This is likely due to the difficulty in sterilising chlorhexidine.

I have two questions

1. Are skin cleansing swabs TGA approved for use on invasive medical devices such as PIVC, Central lines? (regardless of whether they are non-sterile 2% chlorhexidine & 70% isopropyl alcohol skin cleansing swabs or sterile 70% isopropyl alcohol)

2. Does use of non-sterile chlorhexidine/alcohol combination skin cleansing swabs for active disinfection of IV access hubs accord with aseptic technique principles? How is it any different from the expectation that sterile 70% alcohol swabs are used for active disinfection of the rubber stoppers on medication vials prior to accessing. (That’s certainly the standard within sterile prep areas in Pharmacies)

I’m very interested in your opinion and the current practice of your organisation.

Thank you.

Simon

Simon Meyer-Henry CICP-E | A/Coordinator
Infection Prevention & Management
Royal Perth Bentley Group
Level 6, A Block, Wellington Street, Perth, WA, 6000
T: (08) 9224 2805 M: 0437212588
E: Simon.Meyer-Henry@health.wa.gov.au
W: http://www.rph.health.wa.gov.au

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