Betadine? Alcohol? (one, the other, or both?)

  1. Attended an IV inservice yesterday where a debate broke out about proper IV site prep.

    The (very qualified) speaker/presenter thought that Betadine alone should suffice, and is how she practices.

    One of our more experienced nurses piped up to say all she ever uses is alcohol alone and that she did not have any instances of site problems.

    I've always used an alcohol prep to defat the area, followed by a betadine prep (allowed to do some drying) to prep my sites. I actually did a research paper on this years ago that convinced me this was the best technique to use, was taught this technique in school, and it is our hospital policy as site prep.

    It's been a long time since I've seen any new research on this. What do you guys do?
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  2. 23 Comments

  3. by   jnette
    Interesting... our policy has us doing the exact opposite. Betadine first, let sit 5 minutes, then the alch. prep.
  4. by   susanmary
    My hospital's policy is alcohol then betadine.
  5. by   caroladybelle
    I was always taught that alcohol rub for 30 seconds was just as effective as betadine.

    However, some Onco units are going to chlorahexidine swabs - more effective and does not require drying time to be effective, and less reactions than betadine.
  6. by   Spidey's mom
    Policy says Betadine first and let it dry . . then alcohol.

    But most of us just use alcohol.

    steph
  7. by   VickyRN
    Alcohol, then betadine.
  8. by   mattsmom81
    Regarding betadine: I thought recent studies showed betadine was no longer a good choice for tissue healing thus was no longer recommended, particularly for the 'painting'' of postop surgical sites, etc. (Try convincing our surgeons of that though.

    I'm also running into lots of betadine sensitivities/allergies lately...anyone else? We used to do lots of betadine scrubs/preps...now we use Phisohex or similar.

    Our policies regarding peripheral IV site prep is vigorous alcohol prep alone...no betadine at all. Although the docs like to prep with betadine yet for central lines...betadine first, then alcohol.
  9. by   flashpoint
    Our latest and greatest is phiso-hex...one of our surgeons orders plain old soap and water.

    What do you all use to secure your sites? We're debating that right now. We're using tape and a sterile dressing like opsite, but we're talking about using steri-strips instead of tape.
  10. by   zambezi
    We use alcohol then betadine...we use a venigaurd to secure it (foam tape with a little window, kind of a keyhole shape, with the window in the middle, works well...comes with some extra straight pieces to tape the tubing...)
  11. by   NurseJacqui
    The reason why betadine is preferred over alchohol is because it is bacteriocidal, while alchohol is only bacteriostatic. Using betadine actually kills the existing bacteria present at the site while alchohol only prevents it from growing. That's why iodine/betadine is used in surgery Just because you have never had a problem doesn't mean that you can't use an extra ounce of prevention, especially in an immunosupressed patient. If the patient is allergic to iodine/betadine you can cleanse the area with soap and water and then prep the site with alchohol.
  12. by   NurseJacqui
    We only use the chlorohexadine for ports.
  13. by   geekgolightly
    Originally posted by TerraRN
    The reason why betadine is preferred over alchohol is because it is bacteriocidal, while alchohol is only bacteriostatic. Using betadine actually kills the existing bacteria present at the site while alchohol only prevents it from growing. That's why iodine/betadine is used in surgery Just because you have never had a problem doesn't mean that you can't use an extra ounce of prevention, especially in an immunosupressed patient. If the patient is allergic to iodine/betadine you can cleanse the area with soap and water and then prep the site with alchohol.
    so alcohol then betadine or betadine then alcohol or does it not matter?

    curious.
  14. by   jemb
    We use just alcohol scrubs for peripheral IV sticks. For ports, and for all central line dressing changes, we have started using chlorohexadine, though. We had previously used alcohol first, then betadine for those sites, and still use that for PICC line insertions.

    The following info is from www.apic.org (infection control association) . They say either/or.

    Cutaneous antisepsis
    1. Disinfect clean skin with an appropriate antiseptic before catheter insertion and during dressing changes. Although a 2% chlorhexidine-based preparation is preferred, tincture of iodine, an iodophor, or 70% alcohol can be used (73,75,207,208). Category IA
    2. No recommendation can be made for the use of chlorhexidine in infants aged <2 months. Unresolved issue
    3. Allow the antiseptic to remain on the insertion site and to air dry before catheter insertion. Allow povidone iodine to remain on the skin for at least 2 minutes, or longer if it is not yet dry before insertion (73,75,207,208). Category IB
    4. Do not apply organic solvents (e.g., acetone and ether) to the skin before insertion of catheters or during dressing changes (209). Category IA

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