Abstract

Purpose

This article provides a description of polyhexamethylene biguanide (PHMB), its current uses and clinical outcomes, and potential uses.

Review of Relevant Literature

PHMB is an antiseptic agent from the cationic biocide family, which also includes chlorhexidine. In vitro testing has found it to be effective against gram-positive and gram-negative bacteria including methicillin-resistant staphylococcus aureus, fungi and viruses. Its action is directed toward disruption of the cell wall, a mechanism not known for developing resistance. PHMB is currently used for many other products and industries for more than 50 years. Dressings impregnated with PHMB are now successfully being used to prevent surgical site infections.

Discussion

Elimination of catheter-related bloodstream infection (CR-BSI) is now the achievable goal for all healthcare settings. The use of PHMB provides another engineering tool targeting the skin as the source of these infections. Successful use with prevention of surgical site infections is now being reported. These wounds can become infected with the same organisms as those found in CRBSI.

Implications for Clinical Practice

This agent should be considered for clinical studies to determine the rates of CRBSI reduction resulting from its use.

Abstract

OBJECTIVE: The primary aim of this project is to reduce the incidence of 3 Fr. Groshong^™ PICC occlusions through focused nursing education. BACKGROUND: The use of Peripherally Inserted Central Catheters (PICC) has become an essential tool in the care of pediatric patients. The small lumen and long length of PICCs requires specialized skill and knowledge in proper care, maintenance and flushing in order to prevent catheter occlusion and other complications. Occluded catheters compromise patient care and increase costs. Reducing the incidence of catheter occlusion, will have a significant impact on the quality of patient care; patient, family and nursing satisfaction, patient outcomes, and costs. METHODS: A pre-test/post-test design using a convenience sample of all the core staff nurses working on the medical/surgical unit at a Southern California Children's Hospital was utilized. Objective measures included a written assessment of nursing knowledge, direct observations of nurses' flushing technique, and retrospective chart review to determine the rate of total catheter occlusion. RESULTS: Mean written test scores improved from 0.78 to 0.93 (p=0.00) Mean observation scores improved from 0.88 to 0.95, (p=0.004). The pre-test occlusion rate was 21.11/1000 catheter days. The post test occlusion rate was 15.49/1000 catheter days (p=0.057). CONCLUSION: Focused nursing education contributed to reducing 3F Groshong^™ PICC occlusions and the associated costs due to PICC occlusions.