Prevention of Central Line Infections

Paper Summary:

This study reviews and assesses data from previous meta-studies that compared the actions of the skin antiseptics, Chloraprep and Providone Iodine among others, with regard to sterilization prior to catheter insertion. The study reassess the available data in an attempt to understand whether the findings remain conclusive in supporting the use of chlorhexidine over Providone Iodine solution in prevention of catheter related blood stream infection (CRBSIs). The paper relates that the clinical problem statement is 'What are the most effective antiseptic techniques to use to minimize risk of infection from use of intravenous catheters". The study attempts to solve this clinical problem statement through a thorough review of the clinical trials which have been conducted globally since the introduction of chlorhexidine.

Outline:
Definitions
Introduction
Problem Statement
Description of Methodology
Presentation of Findings
Synthesis of Findings

From the Paper:

"Several studies have now been completed to compare the actions of the skin antiseptics Chloraprep and Providone Iodine among others. The results of a Meta-Analysis study "found that the use of Chlorhexidine gluconate rather than Providone Iodine can reduce the risk for catheter-related blood stream infection by approximately 50% in hospitalized patients who require short-term catheterization." The study goes on to state "Given the extent of the benefit and the small incremental cost, chlorhexidine gluconate should be considered as a replacement for Providone Iodine solution, particularly in patients at high risk for catheter related blood stream infection."

Sample of Sources Used:

• Adams, D., Quavum, M., Worthington, T., Lambert, P., & Elliott, T. (2005). Evaluation of a 2% chlorhexidine gluconate in 70% isopropyl alcohol skin disinfectant. Journal of Hospital Infections, 61 (4), 287-290.
• Brungs, S., & Render, M. (2006). Using Evidence-Based Practice to Reduce Central line Infections. Clinical Journal of Oncology Nursing, 10 (6), 723-725.
• CDC. (2002). Guidelines for Prevention of Intravascular Catheter-Related Infections. Morbidity and Mortality Weekly Report; Recommendations and Reports, 51 (RR-10), 1-34.
• CDC Mission. (n.d.). Retrieved February 6, 2006, from CDC Web site: http://www.cdc.gov/about/mission.htm
• Chaiyakunapruk, N., Veenstra, P. D. L., Lipsky, P. B. A., & Saint, M. S., MD. (2002). Chlorhexidine Compared with Providone-iodine Solution for Vascular Catheter-Site Care: A Meta-Analysis. Annals of Internal Medicine, 136, 792-801.

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