Individual research recommendation details

Recommendation ID

CG139/6

Question

Vascular access devices: skin decontamination:- What is the clinical and cost effectiveness of 2% chlorhexidine in alcohol versus 0.5% chlorhexidine in alcohol versus 2% chlorhexidine aqueous solution versus 0.5% chlorhexidine aqueous solution for cleansing skin (before insertion of peripheral vascular access devices [VADs] and during dressing changes of all VADs) in reducing VAD-related bacteraemia and VAD site infections?

Any explanatory notes
(if applicable)

Why this is important:- The effective management of VADs is important for reducing phlebitis and bacteraemia. In the community, compliance is improved when a single solution is used for all aspects of VAD-related skin care. There is no direct evidence comparing different percentages of chlorhexidine in aqueous and alcohol solutions, and little evidence on the use of such solutions in the community.
A randomised controlled trial is required to compare the clinical and cost effectiveness of the different solutions available. The trial should enrol patients in the community with a VAD. The protocol would need to use the same skin preparation technique regardless of solution, and could also investigate the effects of decontamination technique and drying time. The primary outcome measures should be rate of VAD-related bacteraemia, rate of VAD site infections, mortality, cost and quality of life. Secondary outcome measures should include visual infusion
phlebitis (VIP) score, insertion times and skin irritation.

Source guidance details

Comes from guidance

Healthcare-associated infections: prevention and control in primary and community care

Number

CG139

Date issued

March 2012

Other details