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Best practice skin antisepsis for insertion of peripheral catheters

14 January 2021

Infection Prevention

02 January 2021

Volume 30 · Issue 1

ISSN (print): 0966-0461

ISSN (online): 2052-2819

Abstract

This article discusses the importance of effective skin antisepsis prior to the insertion of peripheral intravenous catheters (PIVCs) and how best clinical practice is promoted by application of an appropriate method of skin disinfection integrated effectively with a proprietary aseptic non touch technique, or other standard aseptic technique. Historically under-reported, incidence of infection and risk to patients from PIVCs is now increasingly being recognised, with new research and evidence raising concern and helping to drive new clinical guidance and improvement. The risks posed by PIVCs are particularly significant given increasing PIVC dwell times, due to cannula removal now being determined by new guidance for clinical indication, rather than predefined time frames. Clinical ‘best practice’ is considered in context of the evidence base, importantly including availability and access to appropriate skin antisepsis products. In the UK, and other countries, ChloraPrep is the only skin antisepsis applicator licensed as a drug to disinfect skin and help prevent infections before invasive medical procedures, such as injections, blood sampling, insertion of PIVCs and minor or major surgery.

Recent healthcare modelling based on published data has estimated 653 000 healthcare-associated infections (HAIs) annually among adult inpatients in English NHS hospitals, with 22 800 annual deaths (Guest et al, 2020). Collectively, the cost to the NHS in England of these challenging numbers is a staggering £2.7 billion. Bloodstream infections represent an estimated 7.3% of the total HAIs (Guest et al, 2020) with as many as 70% of catheter-associated bloodstream infections (CABSIs) thought to be preventable (Umscheid et al, 2011). Peripheral intravenous catheters (PIVCs) are the most frequently used invasive devices in hospitals with estimates as high as 70% of all inpatients requiring a PIVC during their stay in the hospital environment (Zingg et al, 2009). Based on NHS Supply Chain data, more than 300 English NHS trusts purchase more than 25 million safety peripheral intravenous catheters (SPIVCs) annually (NHS Clinical Evaluation Team, 2018).

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ANTT

Aseptic technique

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ChloraPrep