CHG compatibility and CRBSI Reduction: Does it Matter?

The last blog began a 3-part series focusing on catheter-related bloodstream infections (CRBSIs). We saw that as vascular catheter use has increased, bloodstream infections have become a costly complication of health care. We also reviewed how preventing dressing disruption with Mastisol Liquid Adhesive® reduces the likelihood of dressing displacement and minimizes the risk of infection. (View Blog 1 of 3) In this second part of the series, we will examine the impact of products compatible with chlorhexidine gluconate (CHG) have on CRBSIs.

With estimates of over 250,000 CRBSIs occurring annually in the US1, it is clearly an issue that healthcare practices and facilities must address. One of the effective strategies used to combat microbial access to catheter insertion sites—and also recommended by the CDC in their Infusion Therapy Guidelines2 —is what is often considered the “gold standard” of antimicrobials, chlorhexidine gluconate, also known as CHG.

Reasons alcohol-based CHG is
the preferred antiseptic3

  • residual activity
  • fast dry time
  • broad spectrum activity
    • gram-positive bacteria
    • gram-negative bacteria
    • facultative anaerobes and aerobes
    • yeasts
    • some lipid-enveloped viruses

One of the unique features of CHG is its sustained activity against a broad spectrum of gram-negative and gram-positive bacteria, yeast and lipid-enveloped viruses.3

Knowing that dressing disruption increases the risk of CRBSIs, maintaining dressing integrity will help diminish the risk of infection and reduce unplanned dressing changes and associated costs.2

Frequently, improved dressing adherence is enhanced with the use of a gum mastic liquid adhesive, yet one might wonder, are all adhesives compatible with CHG?

To that end, the Journal of Infusion Nursing recently published a prospective, randomized, blocked-design trial that evaluated the compatibility of a gum mastic liquid adhesive (GMLA) and a liquid adhesive remover with an alcohol-based chlorhexidine gluconate skin prep. The 2 commercial test products evaluated for compatibility with a 2% CHG and 70% IPA antiseptic skin preparation were Mastisol® Liquid Adhesive, a non–water-soluble gum mastic liquid adhesive (GMLA) and Detachol® Adhesive Remover, a nonirritating liquid adhesive (LAR).3

The study demonstrated that: 3

  • Mastisol® and Detachol® were compatible with CHG applied to the skin
  • There were no statistically significant differences in bacterial populations following use of the CHG/IPA product alone versus use of the CHG/IPA product with either product at both 3 and 7 days after application

The documented compatibility of Mastisol® with CHG ensures that use of this liquid adhesive will not compromise the antiseptic protection of the insertion-site wound against transient organisms and contamination. Moreover, the use of Detachol® with CHG can ensure that appropriate technique is used for dressing removal, without impairing antiseptic coverage.3

The study concluded that GMLAs and LARs should be considered important additions to dressing management policies and maintenance care bundles. However, all GMLAs and LARs are not created equally—not all have proven CHG compatibility.3

For more information about Mastisol® and Detachol®, please contact your sales consultant or Eloquest Healthcare®, Inc., call 1-877-433-7626 or visit www.eloquesthealthcare.com.

Minimizing infection risk is an essential part of optimizing “The Triple Aim” of the Affordable Care Act. Eloquest Healthcare is committed to providing solutions that can help you reduce risk of conditions like a CAUTI, CLABSI, or SSI.

Join us next time for the last of this 3-part series, “CRBSIs & Dressing Disruption: QI Initiatives Demonstrate Improved Adherence.

References

  1. Shah H, Bosch W, Thompson KM, et al. Intravascular catheter-related bloodstream infection. Neurohospitalist. 2013;3(3):144-151.
  2. O’Grady NP, Alexander M, Burns LA, et al; Healthcare Infection Control Practices Advisory Committee. Guidelines for the prevention of intravascular catheter-related infections. Am J Infect Control. 2011; 39(4 Suppl 1): S1-34. doi: 10.1016/j.ajic.2011.01.033.
  3. Ryder M, Duley C. Evaluation of compatibility of a gum mastic liquid adhesive and liquid adhesive remover with an alcoholic chlorhexidine gluconate skin preparation. J Infus Nurs. 2016;40(4):245-252.