Re: Chloroscrub vs. alcohol swabs

[Martha Pike]

My understanding from reading many studies, pharmacy text book info on antiseptics, and product info sheets, is that chlorhexidine does provide an immediate broad spectrum antimicrobial effect.  Using an alcohol base for the solution enhances the immediacy as well as improving the drying time. (All products available in the US are alcohol based solutions.) This is what makes it preferable to PVP products. Chlorhexidine also has a sustained effectiveness  after it dries- how long depends on the particular product formula. And it has an increasing sustained effectiveness with repeated usage (check out some of the hand-washing studies). In contrast, povidone iodine (PVP, Betadine) has no immediate effect. PVP allows a slow release of iodine and takes about 2 minutes to be fully effective (so if you remove it with alcohol to see the vein, you've wasted your time using it).  PVP is also an aqueous based solution which means some bugs will grow in it. There is no effect from PVP after the prep is fully dry. /Martha On Mar 9, 2006, at 7:30 PM, [EMAIL PROTECTED] wrote: Tami,   Several well known practioners and authors who post here often have showed us enough evidence and reason why a Phenergan that a policy might be in line at every institution. Perhaps it is time for yours to consider it.   But barring that why not share your documentation/research, in a non-threatening way, with the instructor in question. Perhaps you can make a convert.   As to Chlorhexidine containing swabs, I don't know if there has been any studies done on port swabbing. But again from the boring logical/theoretical side the Chlorhexidine has little instant kill. If it lingers on the port it might help keep contamination down for later accesses.   Alcohol give the broad spectrum instant kill we need. So whatever you use it should contain 70-80% alcohol as well to assure you are killing those nasty bugs now.   Tony West, RN, CRNI Healix, Inc. Email: [EMAIL PROTECTED] or [EMAIL PROTECTED] SMS: [EMAIL PROTECTED] Cell: 214-674-4848   In a message dated 3/9/2006 6:10:02 P.M. Central Standard Time, [EMAIL PROTECTED] writes: Questions for the group:  2.  We have the ability to now use the Chloroscrub Swabs in our hospital. They are, however, more expensive than alcohol swabs. We are trying to decide what to ask our hospital for regarding what we need and what we would use the swabs for. Most of our nurses don’t spend the required amount of time swabbing hubs/caps with the alcohol swabs. Is anyone else switching over to these swabs in place of the alcohol swabs? And, if you are, are you using them for all IVs or just for central lines? Our local college has clinical for the nursing students at our hospital. At a recent staff meeting one of the instructors said she will not require her students to dilute IV Phenergan unless we make a policy. In looking up Phenergan in two Mosby’s we have, we found one states to dilute and the other says it is optional to dilute before giving. Our PICC team knows the affects Phenergan if it infiltrates into the tissues. I look at this as being a normal, common sense ‘nursing consideration’ for a medication. Many medications have ‘nursing considerations’, they don’t all need a policy to back it up. Any thoughts?     Tami Spaeder, RN, BSN