Infusion Therapy – ChloraPrep® Use SECTION: 25.15
Strength of Evidence Level: 3 __RN__LPN/LVN__HHA
PURPOSE:
To decrease the possibility of central line site infection(s) through the use of antiseptic agents at the catheter exit site.
CONSIDERATIONS:
1. Central Line:
a. Remember to have the patient turn their head away from the central line site while the dressing is being removed to prevent contamination from sneezing, etc.
b. If patient is unable to turn their head, a mask should be considered.
ChloraPrep® (chlorhexidine gluconate):
1. DO NOT use on children less than 2 months of age because of the potential for excessive skin irritation and increased drug absorption.
a. DO NOT use on patients with known allergies to chlorhexidine gluconate or isopropyl alcohol.
b. DO NOT use on open wounds or as a general skin cleanser.
c. Avoid contact of ChloraPrep® with patient’s eyes.
d. Bloody drainage does not inactivate chlorhexidine gluconate and is not required to be cleaned off first. However, if the amount of drainage is sufficient enough that one application of chlorhexidine gluconate would not remove it, alcohol swabs may be used first to remove the drainage prior to proceeding to cleansing the skin with chlorhexidine gluconate.
f. ChloraPrep® is a broad spectrum antiseptic, hich has prolonged residual kill activity up to 5 days.
EQUIPMENT:
Central line dressing kit
Non-sterile and sterile gloves
Mask
ChloraPrep® product kit
Tape
Alcohol swabs
PROCEDURE:
1. Adhere to Standard Precautions.
2. Explain the procedure to the patient and/or caregiver(s). Determine whether the patient has any allergies to products containing chlorhexidine gluconate or isopropyl alcohol.
3. Assemble supplies, including the dressing change kit, ChloraPrep® and alcohol swabs.
4. Wash hands. Don non-sterile gloves.
5. Loosen the clear or gauze dressing carefully and separate it from the skin without pulling on the central line.
6. Assess the central line site for signs of infection, including drainage, redness, odor or inflammation.
7. Remove non-sterile gloves and dispose of soiled dressing properly.
8. Using sterile technique, open central line dressing change kit and establish sterile field.
9. Open ChloraPrep® package and add to sterile field, if not included in central venous catheter (CVC) dressing kit.
10. Don sterile gloves.
11. Instructions for using ChloraPrep® Swabstick Applicator:
a. Tear pouch at side notch to reveal applicator handle.
b. DO NOT touch applicator tip when removing applicator from pouch.
c. Use repeated back-and-forth stokes of applicator for approximately 30 seconds.
d. Completely wet the treatment area with antiseptic.
e. Allow the area to air dry for approximately one minute. DO NOT blot or wipe away.
f. Discard the applicator after a single use.
12. Instructions for using ChloraPrep® One-Step Applicator:
a. Pinch the wings on the applicator to break the ampule and release the antiseptic.
b. DO NOT touch the sponge. Wet the sponge by repeatedly pressing and releasing the sponge against the treatment area until liquid is visible on the skin.
c. Use repeated back-and-forth strokes of the applicator for approximately 30 seconds.
d. Completely wet the treatment area with antiseptic.
e. Allow the area to air dry for approximately 30 seconds. DO NOT BLOT OR WIPE AWAY.
13. (See Infusion Therapy- Central Venous Therapy Gauze Dressing Change.)
AFTER CARE:
1. Document in patient’s record:
a. Type and appearance of venous access site.
b. Patient’s response to procedure.
c. Instructions given to patient/caregivers.
d. Response to training.
e. Communication with physician.
REFERENCE:
Centers for Disease Control and Prevention (CDC), Guidelines for the Prevention of Intravascular Catheter-Related Infections