Drying Chlorhexidine

[PNW_NPstudent]

Reaching out to OR peeps.

I work in a procedural area, not OR, but we adhere to "maximum barrier" for procedures. One of the techs applies chlorhexidine and fans it dry because "my drape wont stick with it wet." I thought the solution was required to be air dried. I cant seem to find anything on AORN site or by googling for an answer. Thoughts? And do you know of anything for EBP that I could share?

[jenam2you]

It is meant to be air-dried because "fanning it" just drops germs over the area that was just cleaned.

[Rose_Queen, BSN, MSN, RN]

And I believe if you read the manufacturer's instructions, it will list the required dry time- we use 26mL applicators of Chloraprep, and the policy stating we must wait three minutes for dry time before placing drapes is because that is what was stated by the manufacturer. That's the reason that for true emergencies that are termed "splash and slash", we use betadine to prep- just open the bottle and pour.

This is directly from the FAQs on the Chloraprep website:

Additional labeled warnings of ChloraPrep preoperative skin preparation include:

• Solution contains alcohol and gives off flammable vapors—allow to dry three minutes on hairless skin.
  
• Do not drape or use ignition source (e.g., cautery, laser) until solution is completely dry (minimum of three minutes on hairless skin; up to 1 hour in hair).
  
• Avoid getting solution into hairy areas, as wet hair is flammable; Hair may take up to 1 hour to dry. Reduced dry time for smaller applicators.
  
• Do not allow the solution to pool.
  
• Remove any soaked materials, drapes and gowns before using ignition sources.
  
• Whenever prepping the neck area, place towels under each side to absorb excess solution and then remove.
  

[canned_bread]

Fanning it would cause air particles to drop onto the area, it is poor infection practice. This is the same for "shaking hands out" after scrubbing, it's a no no that I see so often.

In our facility for chlorhexidine we wait 3 minutes (whilst the scrub may do other things in preparation) and then if it is still very wet we use a sterile gauze and dab from inside to out in the area that is wet. Sometimes it remains a little moist still, but that's okay, it's still doing it's work, and the drape mostly sticks.

For povidine-iodine, it is recommended 2 minutes and then the same dab of sterile gauze can occur. I find iodine dries a lot quicker.

Personally, when I scrub, I do the prep as soon as I can and let it dry whilst I do other setting up of my trolley and instruments, and then turn back and its hopefully dry.

[schnookimz]

Isn't the three minute dry time because it's flammable?!? You better tell that scrub to slow down. No fanning and must wait three minutes!

[MedMayhem]

Like the others said, it should air dry without fanning because it could spread non-sterile particles all over the sterile field, negating the whole point of the prep. Plus, it should be pretty dry at the manufacturer-recommended 3 minutes (one hour for prep over hair, not that anyone I've ever seen follows that guideline). If she really wants it dry, she should just dab with a sterile towel. The immediate bacteriocidal effect comes from the actual drying of the alcohol.

[PNW_NPstudent]

Thanks guys. I knew I wasn't crazy! Written policy for the department now! :)