Yamamoto, N., Kimura, H., Misao, H., Matsumoto, H., Imafuku, Y., Watanabe, A., . . . Kanemitsu, K. (2014). Efficacy of 1.0% chlorhexidine-gluconate ethanol compared with 10% povidone-iodine for long-term central venous catheter care in hematology departments: A prospective study. American Journal of Infection Control, 42, 574–576.
To evaluate the effectivness of 1% chlorhexidine-gluconate ethanol (CHG-EtOH) versus 10% povidone-iodine among patients with hematologic malignancies and central line catheters
Randomized, controlled trial
CVC exit site colonization rates were 11.9% with chlorhexidine and 29.2% with povidone-iodine (p = 0.03). CLABSI rates were 3.4% with chlorhexidine and 14.6% with povidone-iodine (p = 0.08). The incidence per catheter days was higher in the povidone iodine group (RR = 0.23, p = 0.041).
This study suggests that the use of 1% CHG-EtOH while preparing patients for the insertion of a central line and while dealing with central lines on a daily basis decreases the CLABSI rate as compared to the use of 10% povidone-iodine. This affects the length of a patient's stay in the hospital and delays the discharge process.
Nurses always are on the front line giving care to patients, and it is their responsibility to prevent the transmission of infection and provide quality care. One of the most certain ways of giving an infection to a patient is through a central line. These findings suggest that the use of 1% CHG-EtOH while manipulating central lines helps decrease the chance of CVC site contamination and may be more effective than povidone-iodine. However, study limitations reduce the strength of this particular finding. Additional studies of the most effective methods for skin preparation would be helpful.