Date of Graduation

5-2014

Document Type

Thesis

Degree Name

Bachelor of Science in Nursing

Degree Level

Undergraduate

Department

Nursing

Advisor

Scott, Allison

Reader

Smith-Blair, Nan

Second Reader

Gentry, Jacklyn

Abstract

Central venous catheters (CVCs) are inserted in order to administer fluids and medications. A peripherally inserted central catheter (PICC) is a type of CVC. While beneficial, central line associated bloodstream infection (CLABSI) is a risk for patients having a CVC inserted. Antiseptics are used for skin preparation when inserting a central line to prevent infection and during maintenance of the central line. Currently, the Center for Disease Control recommends the use of chlorhexidine for central venous catheter insertion in patients two months of age or older. Studies have found reduced CLABSI rates with the use of chlorhexidine for CVC insertion and maintenance in neonates. Research has also found chlorhexidine to have a more substantial and longer lasting effect than povidone- iodine as an antiseptic. However, studies have also noted concerns related to skin irritation and burns in low weight neonates with the use of chlorhexidine. Additional research is needed to determine the efficacy of chlorhexidine in preventing CLABSI infections in the neonatal population. This study compared the CLABSI rate in a Northwest Arkansas neonatal intensive care unit (NICU) with the use of povidone-iodine versus chlorhexidine as the antiseptic for PICC line maintenance. The study examined all neonates in the NICU who had a PICC line. The data was analyzed using a descriptive statistics examining CLABSI with the use of povidone-iodine versus chlorhexidine as the antiseptic. One CLABSI occurred during the povidone-iodine protocol. No infection occurred during the chlorhexidine protocol. Because of the small infection rate during the timeframe of this study, it was concluded that both antiseptics were effective at preventing CLABSI in neonates with PICCs. This study was limited in scope and timeframe therefore more extensive research could be conducted to further examine if the new chlorhexidine protocol is more effective at preventing CLABSI in the neonatal population with PICCs.

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