Effectiveness of alcohol??

[Lady_in_red]

A doctor recently told me that the alcohol prep pads we use before starting an IV or administering an injection are useless. He said there is no literature to support alcohol as an effective means of reducing infections before these procedures and that cleaning in a circular motion did nothing as well. Needless to say, I was surprised! My instructors have been adament about both of these subjects. I did a short literature review and I can't find anything useful. I found research studies in favor of the alcohol hand sanitizer, but not for the little alchol wipes. Anyone have any links or information? If what he said is true, then I would like to use a different antiseptic.

I've used search words like "alcohol prep" "alcohol" "Bacteria" "nosocomial infection" "prevention" "preparation" & "injection" in the word search.

Any suggestions would be appreciated.

Thanks for your help!

[BittyBabyGrower, MSN, RN]

cloroprep for IV and art sticks here.

[TazziRN, RN]

If you wipe off betadine with alcohol, you have nullified any good the betadine does. You're supposed to just wipe it off with a dry sterile gauze. Something about the betadine-alcohol combination.

[prmenrs, RN]

If you don't clean off the Betadine (@ least in babies) you can't see the vein.

Betadine works by killing the bacteria as it is drying. Once it's dry, you should be able to use the alcohol w/o a problem. Unless there is some new info.... The chlorhexidine is really a better prep for a blood culture, I think.

[Ann RN]

If you wipe off betadine with alcohol, you have nullified any good the betadine does. You're supposed to just wipe it off with a dry sterile gauze. Something about the betadine-alcohol combination.

Same thing with betadine & peroxide.

[BittyBabyGrower, MSN, RN]

Actually, we really limit the amount of betadine we use as with the preemies we don't really know how much they absorb. You are supposed to leave the betadine on when you stick and it was found that these kids were having out of whack thyroids. The chloroprep is also better as you only have to use one spongie things compared to using 3 betadine swabs and having to wait for each of those to dry before you went on.

[caroladybelle, BSN, RN]

The alcohol helps mechanically clean the skin, and does kill some bacteria. Decreasing the # of bacteria on a piece of skin

Agree with this. That is why you are supposed to scrub the site with the swab not just give it a wipe.

Chloroprep is antimicrobial swab of choice these days.

[caroladybelle, BSN, RN]

If you wipe off betadine with alcohol, you have nullified any good the betadine does.

Many onco units go with this but do not wipe betadine off unless there is excess - then they just blot the excess. It is supposed to dry on there, so that it can continue to fight germs. When you wipe it off before it has dried, you impair it's function.

Several problems. Patients don't like the look, nurses think it looks messy and gets in the way of assessing the central line site or starting a peripheral line. It can also irritate the skin. It also is not as effective as chloroprep. Though chloroprep can sting more on irritated skin.

(I have seen CNS's in Onco/hemo go absolutely nuts when a new grad either does the brief swipe rather than scrubbing with the alcohol prep, or even better, do a CL dressing change w/betadine first, then promptly wiping it off with alcohol swabs.)

Chloroprep is a much better product really.

[caroladybelle, BSN, RN]

This is merely a thought provoking question:

If the alcohol preps are nearly useless (don't kill a lot of bacteria) then why are all the hand sanitizers the "way to go" in hospitals now? We are told you may use them up to five times before you have to wash your hands (unless you know you got a body substance on them or they are visibly soiled).

Again, friction is a required part of the procedure. If you just half-heartedly swipe your hands, it does little good. With most, you are supposed to rub until it is dry, with the friction assisting with removal of bacteria.

Also, please remember that alcohol rubs are utterly useless against things like CDiff. And many of us work with patients where many are carrying that.

[prmenrs, RN]

BBG is correct about the thyroid issue. We always wiped it all away. Now, as previously stated, chlorhexidine is used.

[nurse4theplanet, RN]

Again, friction is a required part of the procedure. If you just half-heartedly swipe your hands, it does little good. With most, you are supposed to rub until it is dry, with the friction assisting with removal of bacteria.

Also, please remember that alcohol rubs are utterly useless against things like CDiff. And many of us work with patients where many are carrying that.

I'd like to add to this statement in response the question of how alcohol rub is effective. The purpose is to decrease transmission from pt to pt of bacteria, etc. that are on your skins surface. Part of the problem with alcohol wipes for IV insertion is that they only decrease the bacteria on the skin's surface, however, you have normal flora that live beneath the skin's surface (within the depth of your layers of skin) that cannot be reached by the alcohol, and therefore can be introduced into the blood stream when the vein is accessed. When simply doing routine pt care and going from pt to pt, you are just trying to decrease the amount of transmittable bacteria, etc. on your skin's surface...therefore, the alcohol rub is sufficient.

[PHLEBOTOMIST_TO_RN]

As someone who sticks people with sharp things for a living I personally like using betadine. I use it when i draw trauma p.t. ( due to the fact if you get called in to court you dont want to say " oh i used an alcohol pad" if the p.t. just killed someone for DD), and i find them a more effective then Alcohol preps. Also, Chlorprep is used exclusively for BC's.

[Tweety, BSN, RN]

We use an IV prep that is iodine based. Supposedly kills 99% of the germs. We were told not to wipe it away.