Chest Tubes

our policy is cleanse with NS during dressing changes (which are q 48-72 hours + prn)...

We change our dressing's every day, swab with betadine.

Does anyone use a policy at their job regarding cleaning chest tube insertion sites while chest tubes are in place? We have a policy for once they are removed, but when you change the dressing around the chest tubes after they have been in for longer than ideal, what do you use to clean the site around the tube? We have been using soap and water but for some reason we don't have a policy in place. Thanks

We have no policy per se, dressings are changed daily or as ordered and we cleanse the site with Chlorhexidine. More hospitals are using clorhexidine swabs now because so many patients are allergic to betadine. This seems to becoming the norm at most hospitals. My brother is a traveler and he said that they are using chlorhexidine in most of the hospitals he's been in, which includes, Colorado, Arizona, California, Washington, Hawaii, and Illinois.

We use chlorhexidine for other dressing changes such as PICC lines. That is a good recommendation. We've found that Betadine also breaks down tissues if used regularly so we rejected that. I'll bring this up to our committee. Thanks for your input!

We use chlorhexidine for other dressing changes such as PICC lines. That is a good recommendation. We've found that Betadine also breaks down tissues if used regularly so we rejected that. I'll bring this up to our committee. Thanks for your input!

You are very welcome.......glad I could help!:wink2:

Badgernurse,

Umm if you are developing the policy, this is great to ask...however not good if you are using this information to apply tx with your patients.

You need to ask your DON or perhaps you could run into trouble if something does go wrong...I could see this happening...

Your at the BON, you are asked why you did such and such, you state you asked Allnurses.com hmm isn't going to fly with them...you need to go to the DON and request a policy or procedure for such things.

Just my opinion, Annette

You make a good point. This situation came up as we were updating our standards and we found we had no policy for cleaning the sites while chest tubes were still in. The P&P people at our hospital usually like Perry and Potter for a guide to policies but could find no info there. We contacted the CDC and searched for a "best practice" study but could find none. I came here to find out what other hospitals do or if they in fact have policies. Now I have something to take back to a committee and recommend. Then there will be a whole process of red tape before (With the P&P people) this even goes into practice with a pilot. This, I think is much better than what was happening. Nurses were doing all sorts of things from using a soapy sponge to nothing at all and we decided we needed a policy. With all due respect, the DON does not write our policies...we take part in developing our practice. Thanks for your input.

You make a good point. This situation came up as we were updating our standards and we found we had no policy for cleaning the sites while chest tubes were still in. The P&P people at our hospital usually like Perry and Potter for a guide to policies but could find no info there. We contacted the CDC and searched for a "best practice" study but could find none. I came here to find out what other hospitals do or if they in fact have policies. Now I have something to take back to a committee and recommend. Then there will be a whole process of red tape before (With the P&P people) this even goes into practice with a pilot. This, I think is much better than what was happening. Nurses were doing all sorts of things from using a soapy sponge to nothing at all and we decided we needed a policy. With all due respect, the DON does not write our policies...we take part in developing our practice. Thanks for your input.

here in uk we uses chorhexedine if there is signs of too much secretions/ leaks coming out that may compromise tissue/skin a cavilon spray is applied..