Which alternative antiseptic to use for CVC dressing?

[Miss_Morris]

It has been reported that 2% CHG is the antiseptic of choice when it comes to dressing of central line. Unfortunately, our hospital currently has no stock of it. I need to know what other alternatives that we can use when cleaning the central line. We only have CHG 0.1% (blue solution), 10% iodine, and 70% isopropyl alcohol (mediswabs). Some of the RNs I work with use CHG 0.1% but when I enquire with our hospital's Infection Control Unit, CHG 0.1% is used for irrigation, hence isn't a strong enough antiseptic, and recommends using mediswabs. Problem with using only mediswabs is that it's kinda difficult to scrub the area using a back-and-forth motion. Is it ok to clean the area with the CHG 0.1% first using back-and-forth motion, and when it's dry, to clean the site with mediswabs using circular motion?

[KelRN215, BSN, RN]

Your central line dressing kits don't have chloraprep sponges or swabs in them? I have never seen such a kit.

[Clovery]

CDC - 2011 Guidelines for the Prevention of Intravascular Catheter-Related Infections - HICPAC

"Prepare clean skin with a >0.5% chlorhexidine preparation with alcohol before central venous catheter and peripheral arterial catheter insertion and during dressing changes. If there is a contraindication to chlorhexidine, tincture of iodine, an iodophor, or 70% alcohol can be used as alternatives"

I would gather a bunch of references for the use of CHG and present it to whoever writes/enforces policies and orders supplies. Does your facility have biopatches?

[Miss_Morris]

We don't even use central line dressing kits. We use the basic dressing pack which doesn't come with any antiseptic. I was informed by our infection control unit that it's gonna take a while for supplies of 2% CHG. God knows how long it's gonna take. No biopatches as well. They say make do with what you have for now. Unacceptable? Probably. But what else can one do?

[Asystole RN]

Iodaphors were the original standard so I would fall back on that or alcohol based preps if necessary. There are other brands of antimicrobial patches that could be used such as the Bard GuardIVa patches.

I am 99.9% positive that a gentle call to your Carefusion rep would have you in waste deep in Chloraprep by the end of the weekend.

[applewhitern, BSN, RN]

Not every facility uses CareFusion for their supplies. Maybe the company they contracted with has this on backorder for some reason. Before CHG become the standard, we used iodine first, then removed the iodine with the alcohol swabs. Alcohol alone will only defat; it won't kill all the germs.

[ausrnurse]

I would use the iodine. We typically use it for people with chlorhexidine allergies anyway.

[wheeliesurfer]

I was also going to say if the CHG is on backorder maybe you could try for Chloraprep. Ask central supply if there is another vendor they can contact to get you the supplies STAT. If it is backordered with one company, chances are good that another company might still have it in stock.