Chlorhexidine dressings, along with proper patient education, are key in preventing central line-associated blood stream infections in patients with cancer.
Chlorhexidine-impregnated dressings or sponges—as well as patient education—can reduce the rate of central line-associated blood stream infection (CLABSI) in patients with cancer, according to a project implemented by a group of regional nurse directors at the American Oncology Network in Fort Myers, Florida.
Not only can infections increase the susceptibility of patients with cancer for more serious health complications, but they can also lead to delay in treatment, antibiotic usage, and increase in the cost of care, highlighting the need for a standardized operating procedure for infection prevention.
The Oncology Nursing Society and Infusion Nurses Society recommend the use of chlorhexidine-containing dressing around the needle insertion site, based on the duration of the infusions. Therefore, in a study to presented at an upcoming meeting, nurse investigators implemented a strategy using chlorhexidine sponge or dressing over a central line in patients who are going home with a continuous infusion.1-2
“We also have patients that come in for daily treatment [then] they go home and their portacath is accessed for multiple days. And so for those patients, while they may not be getting an infusion overnight at home, their port is still accessed, or they still have that non-tunneled catheter that we want to make sure that is covered with the chlorhexidine dressing,” study investigator Amber Pierce MSN, RN, OCN, said in an interview with Oncology Nursing News.
In addition to tactical actions like using chlorhexidine-impregnated dressings or sponges, patient education can also be essential in decreasing the risk of CLABSI.
“We educate [patients] on making sure the site is clean and dry—not getting wet—and checking the site for redness, swelling, pain and all of your typical symptoms of infection, [including] fever,” study investigator Stacey Hield, BSN, RN, OCN, said in an interview with Oncology Nursing News. “If there are any of those issues, they would definitely give us a call and come in the next day.”
Heild mentioned that patients must also be careful with their surroundings at home; for example, a house pet pawing at or dislodging the port.
“We ask patients to protect that port when they go home,” she said. “When they go home and [are on] a continuous IV infusion, we talk about keeping it close by and making sure that their line is not too long or they’re not tripping over or dislodging the needle.”
Even as technology improves, implementing these basic practices are still going to be key for preventing infection.
“In addition to … education, basic handwashing, and sterile techniques—those are always going to be first and foremost in preventing infection—as technology improves, so is the equipment we’re going to be using,” study investigator Heather Wenberg, BSN, RN, OCN said in an interview with Oncology Nursing News.
“At the end of the day, [infection] prevention and education is our No. 1 [goal],” Pierce said.
References
1. Backler C, Kirmse JM. Access device guidelines: Recommendations for nursing practice and education. 2023:4th ed. Oncology Nursing Society.
2. Nickel B, Gorski LA, Kleidon T, et al. Infusion therapy: Standards of practice. 2024. Infusion Nurses Society.
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