scholarly journals Comparison of alcohol, povidone-iodine and octenidine dihydrochloride as skin disinfectants to reduce bacterial count prior to peripheral venous catheter insertions in newborn infants

2011 ◽  
Vol 51 (5) ◽  
pp. 277 ◽  
Author(s):  
Lily Rundjan ◽  
Rinawati Rohsiswatmo ◽  
Sarah Rafika ◽  
Enty Enty ◽  
Lucky H. Moehario
Keyword(s):  
Povidone Iodine ◽  
Newborn Infants ◽  
Bloodstream Infections ◽  
Venous Catheter ◽  
Bacterial Count ◽  
Peripheral Venous Catheter ◽  
Skin Bacteria ◽  
Skin Disinfection ◽  
Octenidine Dihydrochloride ◽  
Before And After

AbstractBackground Vascular access may increase the risk of bloodstream infections, especially in newborn infants with weak immune systems and requiring invasive supportive care. Skin disinfection prior to peripheral venous catheter insertion lowers the risk of infection. However, antiseptics chosen for this task should be effective and safe for newborn infants.Objective To compare the effectiveness of 70% alcohol (BD alcohol swabs ®), 10% povidone-iodine (Pharma-RSUPNCM), and octenidine (Octenisept ®) as antiseptics for reducing skin bacteria for pre-invasive procedures in neonates.Methods Infants aged less than 28 days, regardless of gestational age, at the Neonatal Unit of Cipto Mangunkusumo Hospital (RSUPNCM) were included in our study. Infants were divided into three groups, each tested with different skin antiseptics (alcohol, povidone-iodine or octenidine). Skin swabs were performed before and after application of skin antiseptic, followed by inoculation onto blood agar plates. Colony-forming units were counted after 18 hours of incubation at 37ºC.Results Ninety subjects were divided into 3 groups of 30, each group using either 70% alcohol swabs, 10% povidone-iodine, or octenidine as skin antiseptic. Skin swabs were taken before and after antiseptic application and drying, as well as 5 minutes after application. The mean reductions in CFU/cm2 (%) after antiseptic application (and fully dried) were 97.54% for povidone-iodine, 97.52% for octenidine, and 89.07% for alcohol. There were no significant differences in mean CFU reductions among the three antiseptics groups (P=0.299). Furthermore, 5 minutes after application, there were still no significant differences in the three antiseptic groups (P=0.289).Conclusions Although octenidine showed a significant bacterial count reduction after application, it was not significantly different from those of alcohol or povidone-iodine. [Paediatr Indones. 2011;51:277-81].

scholarly journals Care of Peripheral Venous Catheter Sites: Advantages of Transparent Film Dressings Over Tape and Gauze

2014 ◽  
Vol 19 (4) ◽  
pp. 256-261 ◽  
Author(s):  
Stéphanie F. Bernatchez
Keyword(s):  
Bloodstream Infections ◽  
Venous Catheter ◽  
The United States ◽  
Central Venous ◽  
Term Care ◽  
Peripheral Venous Catheter ◽  
Care Facilities ◽  
Review Current ◽  
Peripheral Venous Line

AbstractPeripheral intravenous (PIV) catheters are the most commonly used catheters in hospitals, with up to 70% of patients requiring a peripheral venous line during their hospital stay. This represents 200 million PIV catheters used per year in acute-care hospitals in the United States alone. These medical devices are also used in other health care settings, such as long-term care facilities and nursing homes, and common indications include the administration of medications, nutrients, and fluids. These catheters require proper maintenance and care to avoid complications such as phlebitis, infiltration, occlusion, local infection, and bloodstream infection. Recently it has been suggested that PIV catheter use may lead to a higher rate of complications than previously thought. This is important because some studies have claimed that the rate of bloodstream infections due to PIV catheters is actually comparable to the rates observed with central venous catheters, rather than much lower as previously thought. Moreover, catheter-related infections are now seen as largely preventable. Our goal was to review the current literature and provide an overview of the various approaches used to manage PIV catheter sites as well as review current recommendations.

Efficacy of Adding 2% (w/v) Chlorhexidine Gluconate to 70% (v/v) Isopropyl Alcohol for Skin Disinfection Prior to Peripheral Venous Cannulation

2008 ◽  
Vol 29 (10) ◽  
pp. 963-965 ◽  
Author(s):  
Heather Small ◽  
Debra Adams ◽  
Anna L. Casey ◽  
Cynthia T. Crosby ◽  
Peter A. Lambert ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Isopropyl Alcohol ◽  
Venous Catheter ◽  
Chlorhexidine Gluconate ◽  
Venous Cannulation ◽  
Catheter Colonization ◽  
Peripheral Venous Catheter ◽  
Skin Disinfection

We undertook a clinical trial to compare the efficacy of 2% (w/v) chlorhexidine gluconate in 70% (v/v) isopropyl alcohol with the efficacy of 70% (v/v) isopropyl alcohol alone for skin disinfection to prevent peripheral venous catheter colonization and contamination. We found that the addition of 2% chlorhexidine gluconate reduced the number of peripheral venous catheters that were colonized or contaminated.

scholarly journals Peripheral Venous Catheter-related Bloodstream Infections in Hospitalized Children

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Itay Berger ◽  
Tal Cohen ◽  
Eyal Rahmani ◽  
Itzhak Levy ◽  
Alexander Lowenthal ◽  
...  
Keyword(s):  
Bloodstream Infections ◽  
Venous Catheter ◽  
Hospitalized Children ◽  
Peripheral Venous Catheter

scholarly journals Impact of a Central Line Infection Prevention Bundle in Newborn Infants

2016 ◽  
Vol 37 (9) ◽  
pp. 1029-1036 ◽  
Author(s):  
Rowena McMullan ◽  
Adrienne Gordon
Keyword(s):  
Neonatal Intensive Care ◽  
Dwell Time ◽  
Clinical Characteristics ◽  
Infection Prevention ◽  
Newborn Infants ◽  
Bloodstream Infections ◽  
Central Line ◽  
Before And After ◽  
Central Line Infection ◽  
Line Infection

OBJECTIVETo compare central line use and central line–associated bloodstream infection in newborn infants before and after the introduction of a central line infection prevention bundle in order to determine the effectiveness of the bundle and to identify areas for further improvement.DESIGNRetrospective cohort analysis of prospectively collected data.SETTINGLevel 5 neonatal intensive care unit in Sydney, Australia.PATIENTSNewborn infants admitted to the Royal Prince Alfred Hospital Neonatal Intensive Care Unit who had a central venous catheter (CVC) inserted.METHODSData regarding clinical characteristics, CVC use, and infection were collected before and after the introduction of a bundle of interventions. The bundles encompassed (1) insertion of CVC, (2) maintenance of CVC, (3) an education program, and (4) ongoing surveillance and feedback.RESULTSBaseline and intervention groups were comparable in clinical characteristics. The number of CVCs inserted was reduced in the intervention group (central line utilization rate, 0.16 vs 0.2, P<.0001). Overall CVC dwell time was reduced, resulting from significant reduction in peripherally inserted CVC dwell time (6 days [95% CI, 5.0–11.8 days] vs 7.3 days [4.0–10.4 days], P=.0004). Central line–associated bloodstream infections were significantly reduced, predominantly secondary to decreased peripherally inserted CVC–related bloodstream infections (1.2/1,000 central line–days vs 11.5/1,000 central line–days, P<.0001).CONCLUSIONThis central line infection bundle was effective in reducing CVC use, dwell time, and central line–associated bloodstream infections.Infect Control Hosp Epidemiol 2016;37:1029–1036

The use of 3.15% chlorhexidine gluconate/70% alcohol hub disinfection to prevent central line-associated bloodstream infections in dialysis patients

2020 ◽  
Vol 29 (2) ◽  
pp. S24-S26 ◽  
Author(s):  
R. Marty Cooney ◽  
Nisha Manickam ◽  
Paul Becherer ◽  
Laura S. Harmon ◽  
Liza Gregg ◽  
...  
Keyword(s):  
Vascular Grafts ◽  
Bloodstream Infections ◽  
Venous Catheter ◽  
Central Line ◽  
Chlorhexidine Gluconate ◽  
P Value ◽  
Dialysis Patients ◽  
Skin Disinfection ◽  
Confounding Variables ◽  
Inpatient Population

Purpose: Preventing CLABSI events in the dialysis inpatient population represents significant challenges. Bacteremia associated with lines or grafts are common health-associated infections that lead to adverse patient outcomes. Dialysis patients represent a much higher infection risk due to health frequency needs, more frequent hospitalizations, multiple comorbidity issues, fistula functionality, and multiple attempts for line access leading to additional complications, costs, morbidity, and mortality. Methods: An observational study was conducted including central line device days, CLABSI events, and possible confounding variables in admitted dialysis patients. All CLABSI data were identified according to the Centers for Disease Control and Prevention's National Healthcare Safety Network's definitions for CLABSIs. The intervention involved the removal of 70% alcohol swabs and alcohol hub disinfecting caps, then replacing with swabs containing 3.15% chlorhexidine gluconate/70% alcohol for central line hub disinfection and vascular graft access skin disinfection. Results: The 5-year preintervention period (2008–2012) involved 7568 central line days, 11 CLABSI events, and a 1.45 per 1000 device day rate. The 6-month trial period involved 1559 central line days and no CLABSI events. The 5-year postimplementation period (2013–2017) involved 9787 central line days, 5 CLABSI events, and a 0.51 per 1000 device day rate. The postimplementation period represented a statistically significant (P value=0.0493) reduction with 65% fewer CLABSI events compared with the preimplementation period. Limitations: A limitation was variations in scrub time and dry time during central venous catheter hub access. While we were comparing 2 products, behavioral practices using these 2 products were possible influencers and represent a possible confounding variable. Conclusions: This study found that using alcohol with chlorhexidine gluconate prior to accessing central line hubs and vascular grafts allows for reduction in CLABSI events and sustains statistically significant lower CLABSI rates in the inpatient dialysis population. HIGHLIGHTS Using alcohol with chlorhexidine gluconate (CHG) before accessing central line hubs helps reduce central line-associated bloodstream infection (CLABSI) events Using alcohol with CHG before accessing vascular grafts helps reduce CLABSI events A statistically significant reduction (65%) in CLABSI events occurred after use. Statistically significant lower CLABSI rates are sustainable with use of alcohol with CHG

The impact of flushing with pre-filled saline syringes on the incidence of peripheral venous catheter failure: A quasi-experimental study

2019 ◽  
Vol 21 (4) ◽  
pp. 490-496 ◽  
Author(s):  
Patrick Saliba ◽  
Guillermo Cuervo ◽  
Ana Hornero ◽  
Gabriella De Carli ◽  
Alessandra Marani ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Dwell Time ◽  
Venous Catheter ◽  
Hazard Ratio ◽  
Intervention Period ◽  
Peripheral Venous Catheter ◽  
Factors Associated ◽  
Before And After ◽  
Quasi Experimental ◽  
Catheter Failure

Background: Short peripheral venous catheters are one of the most frequently used devices in hospitals. Peripheral venous catheter failure, defined as the unscheduled dysfunction of peripheral venous catheter, is common and frequently entails a new invasive procedure. Flushing the catheter maintains patency and could prolong peripheral venous catheter dwell time. The introduction of pre-filled saline flushing syringes as compared to manually filled saline flushing syringes could facilitate the frequency of catheter flushing, and subsequently it could reduce peripheral venous catheter failure rate. Objective: To demonstrate differences in overall peripheral venous catheter failure rates before and after the introduction of pre-filled saline flushing syringes and to assess the risk factors for peripheral venous catheter failure. Methods: Quasi-experimental design, before-and-after intervention study. Intervention: introduction of pre-filled saline syringes for flushing. Multicenter study conducted in medical and surgical wards of three European hospitals during a 9-month period (4 months pre-intervention, 5 months intervention). A multivariate Cox proportional model was used to identify factors associated with the occurrence of peripheral venous catheter failure. Results: Data from 3853 peripheral venous catheters in 1915 patients were analyzed. Compared to pre-intervention period, a significant decrease in peripheral venous catheter failure rate was observed in the intervention period (57% vs 43.4%, p < 0.001). Independent factors associated with peripheral venous catheter failure were as follows: Charlson score ⩾4 (hazard ratio: 1.648; 95% confidence interval: 1.069–2.527), days of hospital stay ⩾10 (hazard ratio: 1.468; 95% confidence interval: 1.172–1.837), and catheter “D” (hazard ratio: 1.758; 95% confidence interval: 1.058–2.919). Conclusion: The use of pre-filled saline syringes significantly reduced peripheral venous catheter failure and increased catheter dwell time. Thus, it is important to reinforce the use of the pre-filled syringes for flushing to reduce the incidence of peripheral venous catheters’ failure.

An Outbreak of Bloodstream Infections in an Outpatient Hemodialysis Center

2002 ◽  
Vol 23 (12) ◽  
pp. 725-729 ◽  
Author(s):  
Connie S. Price ◽  
Donna Hacek ◽  
Gary A. Noskin ◽  
Lance R. Peterson
Keyword(s):  
Infection Control ◽  
Povidone Iodine ◽  
Bloodstream Infections ◽  
Baseline Period ◽  
Access Site ◽  
Control Programs ◽  
Before And After ◽  
And Control ◽  
Control Study ◽  
Microbiological Data

Objectives:Investigate and control an increase in bloodstream infections (BSIs) in an outpatient hemodialysis center.Patients and Design:A retrospective cohort study was conducted for patients receiving dialysis at the center from February 2000 to April 2001. A case–control study compared microbiological data for all BSIs that occurred during the study period with those for BSIs that occurred during a baseline period Qanuary 1999 to January 2000). BSI rates before and after a 1-month intervention (May 2001) were assessed. A case was defined as a new BSI during the study period.Results:The outbreak was polymicrobial, with approximately 30 species. The baseline BSI rate was 0.7 per 100 patient-months. From February 2000 to April 2001, the BSI rate increased to 4.2 per 100 patient-months. Overall, 75% of the BSIs were associated with central venous catheters (CVCs), but CVC use did not fully explain the increase in BSIs. In January 2000, when the center changed ownership, prepackaged CVC dressing kits and biweekly infection control monitoring were discontinued. Beginning in May 2001, staff were educated on CVC care, chlorhexidine replaced povidone-iodine for cutaneous antisepsis, gauze replaced transparent dressings, antimicrobial ointments containing polyethylene glycol at CVC exit sites were discontinued, and patients with CVCs were educated on cutaneous hygiene. After the intervention period, by October 2001, rates decreased to less than 1 BSI per 100 patient-months.Conclusions:Proper cutaneous antisepsis and access site care is crucial in preventing BSIs in patients receiving hemodialysis. Infection control programs, staff and patient education, and use of optimal antisepsis agents or prepackaged kits are useful toward this end.

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