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Implement the Central Line Bundle:
Chlorhexidine Skin Antisepsis

Chlorhexadine skin antisepsis has been proven to provide better skin antisepsis than other antiseptic agents such as povidone-iodine solutions.

 

The technique, for most kits, is as follows:

  • Prepare skin with antiseptic/detergent chlorhexidine 2 percent in 70 percent isopropyl alcohol.
  • Pinch wings on the chlorhexadine applicator to break open the ampule.  Hold the applicator down to allow the solution to saturate the pad. 
  • Press sponge against skin, apply chlorhexidine solution using a back and forth friction scrub for at least 30 seconds.  Do not wipe or blot.
  • Allow antiseptic solution time to dry completely before puncturing the site (~ 2 minutes).

Tips
  1. Empower nursing to enforce use of a central line checklist to be sure all processes related to central line placement are executed for each line placement.
  2. Include chlorhexadine antisepsis as part of your checklist for central line placement.
  3. Include chlorhexadine antisepsis kits in carts storing central line equipment.  Many central line kits include povidone-iodine kits and these must be avoided.
  4. Ensure that solution dries completely before an attempted line insertion.