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Hi All,
In December last year NSW Health published a guideline called Peripheral Intravenous Cannula (PIVC) Insertion and Post Insertion Care in Adult Patients.
The recommendation for skin preparation states that
“For PIVCs that are inserted in Day only or Extended Day Only patients > 70% alcohol solutions/swabs should be used (to reduce unnecessary exposure to chlorhexidine when residual antimicrobial activity is not required”In the guideline appendix 5 it states that
“For a cannula that is likely to be in for <24hours, skin cleaning with at least 70% alcohol is sufficient"Our facility currently uses an alcoholic chlorhexidine skin prep for all PIVC insertions unless the person has a known sensitivity. We are currently reviewing this and are inclined to continue with this product as we have known of IVC related BSIs occurring when a PIVC has been insitu for less that the 24 hours outlined in this document.
We are interested to know what other facilities are using as skin prep for this cohort of patients.
Kind regards,Fiona De Sousa
Infection Prevention & Control Coordinator
Sydney Adventist Hospital
Fiona.Desousa@sah.org.au
185 Fox Valley Road, Wahroonga, NSW, 2076If you are not the intended recipient you are hereby notified that any dissemination, distribution or reproduction of this message
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Hi Fiona,
Ambulance NSW uses chlorhex / alcohol swabs prep for all PIVC with the full knowledge that their cannulas should be removed ASAP or within 24 hours. We do this because aseptic insertion in emergency situations can be difficult if not impossible to achieve.
Regards,
Kate Hipsley
Manager Infection Control
NSW AmbulanceSent from my iPhone
> On 23 Jan 2014, at 9:35 am, Fiona de Sousa wrote:
>
> Hi All,
>
> In December last year NSW Health published a guideline called Peripheral Intravenous Cannula (PIVC) Insertion and Post Insertion Care in Adult Patients.
>
> The recommendation for skin preparation states that
> For PIVCs that are inserted in Day only or Extended Day Only patients > 70% alcohol solutions/swabs should be used (to reduce unnecessary exposure to chlorhexidine when residual antimicrobial activity is not required
>
> In the guideline appendix 5 it states that
> For a cannula that is likely to be in for
> Our facility currently uses an alcoholic chlorhexidine skin prep for all PIVC insertions unless the person has a known sensitivity. We are currently reviewing this and are inclined to continue with this product as we have known of IVC related BSIs occurring when a PIVC has been insitu for less that the 24 hours outlined in this document.
>
> We are interested to know what other facilities are using as skin prep for this cohort of patients.
> Kind regards,
>
> Fiona De Sousa
> Infection Prevention & Control Coordinator
> Sydney Adventist Hospital
> Mobile: 0408 468 470
> Office: (02) 9487 9732
> Fax: (02) 9472 8053
> Fiona.Desousa@sah.org.au
> 185 Fox Valley Road, Wahroonga, NSW, 2076
>
>
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> You can unsubscribe from this list be sending ‘signoff aicalist’ (without the quotes) to listserv@aicalist.org.auMESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.
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Hi Fiona
Out of interest, the new EPIC guidelines (EPIC3) have been launched in the UK. EPIC guidelines are national evidenced based guidelines for preventing HAI in the NHS in England. Each recommendation has a grading (based on the level of evidence).
There is a new recommendation (for them) relating to cutaneous antisepsis when inserting a peripheral vascular device – “decontaminate the skin with at the insertion site with a single-use application of 2% chlorhexidine gluconate in 70% isopropyl alcohol (or povidone iodine in alcohol for patients with sensitivity to chlorhexidine) and allow to dry before inserting a peripheral vascular device”.
The systematic review processes supporting recommendations are detailed at the back of the guidelines.
The guidelines can be accessed here – http://www.sciencedirect.com/science/article/pii/S0195670113600122
The guidelines cover a range of IC practices.
Thanks
BrettDr Brett Mitchell
Senior Lecturer, RN, BN, PhD, M.Adv.Prac, CICP, MRCNA
Faculty of Nursing and Health
And
Lifestyle Research Centre, Cooranbong
[Description: Description: cid:image001.gif@01CC3C9F.F23555B0]Excellence in Christian Tertiary Education since 1897
185 Fox Valley Road, Wahroonga NSW 2076 AustraliaAvondale College Ltd trading as Avondale College of Higher Education
http://www.avondale.edu.au | http://www.designedforlife.meHi All,
In December last year NSW Health published a guideline called Peripheral Intravenous Cannula (PIVC) Insertion and Post Insertion Care in Adult Patients.
The recommendation for skin preparation states that
“For PIVCs that are inserted in Day only or Extended Day Only patients > 70% alcohol solutions/swabs should be used (to reduce unnecessary exposure to chlorhexidine when residual antimicrobial activity is not required”In the guideline appendix 5 it states that
“For a cannula that is likely to be in for <24hours, skin cleaning with at least 70% alcohol is sufficient"Our facility currently uses an alcoholic chlorhexidine skin prep for all PIVC insertions unless the person has a known sensitivity. We are currently reviewing this and are inclined to continue with this product as we have known of IVC related BSIs occurring when a PIVC has been insitu for less that the 24 hours outlined in this document.
We are interested to know what other facilities are using as skin prep for this cohort of patients.
Kind regards,Fiona De Sousa
Infection Prevention & Control Coordinator
Sydney Adventist Hospital
Fiona.Desousa@sah.org.au
185 Fox Valley Road, Wahroonga, NSW, 2076If 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 Adventist HealthCare Limited to state that they are the views of Adventist HealthCare Limited.
_____________________________________________________________________
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Dear Fiona.
We are using 2 %chlorhexideine 70%V/v Isopropyl alcohol solution for
this purpose. Longer contact time on skin. The Corporate body recently
purchased the ANTT program as it is considered best practice at this
time and skin preparation of choice is that which is described in all
instances.Regards
Liz Vanderlinde
Infection Control Officer
North West Private HospitalBrickport Road, Burnie TAS 7320, Australia
T +61 3 6432 6022 F +61 3 6431 6158
E Liz.Vanderlinde@healthecare.com.au
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immediately.Behalf Of Fiona de Sousa
Hi All,
In December last year NSW Health published a guideline called Peripheral
Intravenous Cannula (PIVC) Insertion and Post Insertion Care in Adult
Patients.The recommendation for skin preparation states that
“For PIVCs that are inserted in Day only or Extended Day Only patients >
70% alcohol solutions/swabs should be used (to reduce unnecessary
exposure to chlorhexidine when residual antimicrobial activity is not
required”In the guideline appendix 5 it states that
“For a cannula that is likely to be in for <24hours,
skin cleaning with at least 70% alcohol is sufficient"Our facility currently uses an alcoholic chlorhexidine skin prep for all
PIVC insertions unless the person has a known sensitivity. We are
currently reviewing this and are inclined to continue with this product
as we have known of IVC related BSIs occurring when a PIVC has been
insitu for less that the 24 hours outlined in this document.We are interested to know what other facilities are using as skin prep
for this cohort of patients.Kind regards,
Fiona De Sousa
Infection Prevention & Control Coordinator
Sydney Adventist Hospital
185 Fox Valley Road, 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 Adventist HealthCare Limited to state that they are the views of
Adventist HealthCare Limited.
_____________________________________________________________________
This e-mail has been scanned for viruses by Symantec Hosted Services
Scanning Services – powered by MessageLabs. For further information
visit http://www.messagelabs.comMESSAGES 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.Archive of all messages are available at http://aicalist.org.au/archives
– registration and login required.Replies to this message will be directed back to the list. To create a
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(without the quotes) to listserv@aicalist.org.auMESSAGES 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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Hi Fiona,
Sorry for the delayed reply as I have just returned from the USA.
CDC 2011 recommend the following;
Skin Preparation
Recommendations
1. Prepare clean skin with an antiseptic (70% alcohol,
tincture of iodine, an iodophor or chlorhexidine gluconate) before
peripheral venous catheter insertion [82]. Category IB2. Prepare clean skin with a >0.5% chlorhexidine preparation
with alcohol before central venous catheter and peripheral arterial
catheter insertion and during dressing changes. If there is a
contraindication to chlorhexidine, tincture of iodine, an iodophor, or
70% alcohol can be used as alternatives [82, 83]. Category IA3. No comparison has been made between using chlorhexidine
preparations with alcohol and povidone-iodine in alcohol to prepare
clean skin. Unresolved issue.4. No recommendation can be made for the safety or efficacy
of chlorhexidine in infants aged
70% alcohol solutions/swabs should be used (to reduce unnecessary
exposure to chlorhexidine when residual antimicrobial activity is not
required”In the guideline appendix 5 it states that
“For a cannula that is likely to be in for <24hours,
skin cleaning with at least 70% alcohol is sufficient"Our facility currently uses an alcoholic chlorhexidine skin prep for all
PIVC insertions unless the person has a known sensitivity. We are
currently reviewing this and are inclined to continue with this product
as we have known of IVC related BSIs occurring when a PIVC has been
insitu for less that the 24 hours outlined in this document.We are interested to know what other facilities are using as skin prep
for this cohort of patients.Kind regards,
Fiona De Sousa
Infection Prevention & Control Coordinator
Sydney Adventist Hospital
185 Fox Valley Road, 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 Adventist HealthCare Limited to state that they are the views of
Adventist HealthCare Limited.
_____________________________________________________________________
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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.Archive of all messages are available at http://aicalist.org.au/archives
– registration and login required.Replies to this message will be directed back to the list. To create a
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