Effect of combination of alcohol and Betadine on the severity of inflammation in the vascular access site in hemodialysis patients

Document Type : Original Quantitative and Qualitative Research Paper

Authors

1 MS in Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran

2 Instructor of Nursing, Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran

3 Phd candidate in Nursing, Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran

Abstract

Background: Inflammation in the vascular access site results in infection, which is the second leading cause of death in hemodialysis patients. However, there is no specific protocol available for sterilization before vascular access in such patients.
Aim: to determine the effect of the combination of alcohol and Betadine on the severity of inflammation in the vascular access site in hemodialysis patients
Methods: In this Randomized Controlled Trial in July 2014, 68 patients undergoing hemodialysis and hospitalized in Imam Reza and Montasereye hospitals of Mashhad, were randomly assigned in two groups of control and combination of alcohol and Betadine group  for one month. In the intervention group, vascular access site was disinfected with Betadine solution and alcohol in 2:1 ratio by the researcher before starting dialysis. The common method of the ward, which was povidone iodine alone, was used to disinfect the vascular access site in control group. The vascular access site of the patients was evaluated by the Iranian Nurses Association's inflammatory criteria during 12 sessions. Data were analyzed by SPSS version 11.5 using Mann-Whitney and chi-square tests.
Results: The mean of age in the intervention group was 46.8±16.6, and in control group was 54.4±1.6. Mean severity of inflammation in the intervention group (0.2±0.2) was lower than that in control group (1.1±0.4) (p<0/05).
Conclusion: The combination of alcohol and Betadine as a disinfectant is effective in reducing the inflammation and consequently the infection in the vascular access site in hemodialysis patients, and nurses can use this antiseptic for vascular access.

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  1. Ostroski S, Drew DA, Lok CE, Cohen JT, Wagner M, Tangri N, Weiner DE. Vascular Access Choice in Incident Hemodialysis Patients: A Decision Analysis. Jo Ame Soc Nephro. 2014;24(4):444-9.
  2. Rayner HC, Zepel L, Fuller DS, Morgenstern H, Karaboyas A, Culleton BF, et al. Recovery Time, Quality of Life, and Mortality in Hemodialysis Patients: The Dialysis Outcomes and Practice Patterns Study (DOPPS). Ame J Kid Dis. 2014; 12(3):124-30.
  3. Sarani H. A Comparative StudyEffect Alcohol after Betadin and Alcohol and Chlorhexidine Inflammation and Infection in Catheterization Vascular Access Hemodialysis Patients.muz J.2011; 2(6):48-55. (Persian)
  4. Rayyani M, Malekyan L, Forouzi MA, Haghdoost A, Razban F. Self.care Self.efficacy and Quality of Life among Patients Receiving Hemodialysis in South.East of Iran. ASI J Nur Edu Res. 2014; 7(2):165.71. (Persian)
  5. Nasri H. Correlation of Serum Magnesium with Serum Levels of 25.hydroxyvitamin D in Hemodialysis Patients. J Para Dis. 2014; 2(1):147-57. (Persian)
  6. Frasca D, Dahyot-Fizelier C, Mimoz O. Prevention of central venous catheter related infection in the intensive care unit.      J Crit Care. 2010; 14(5):212-20.
  7. Ghazvini K. Medical bacteriology a concise textbook. Mashhad: tarjoman khord. 2nd. Mashhad: Andesheh no.2011. p. 165-78. (Persian)
  8. Tashakori M, Moghadam FM, Ziasheikholeslami N, Jafarpour P, Bahsoun M, Hadavi M, et al. Staphylococcus Aureus Nasal Carriage and Patterns of Antibiotic Resistance in Bacterial Isolates from Patients and Staff in a Dialysis Center of Southeast Iran. Ir J Micro. 2014; 6(2):79-83. (Persian)
  9. O’Grady NP, Alexander M, Burns LA, Dellinger EP, Garland J, Heard SO, et al. Summary of Recommendations: Guidelines for the Prevention of Intravascular Catheter Related Infections. Clin INF Dis. 2011; 8(32):1087–99.
  10. Ghazvini K, Namdar H. Medical bacteriology a concise Text book.3nd ed. Mashhad: Ferdosi Mashhad Boshra. 2011:78.100. (Persian)
  11. Goudet V, Timsit J, Lucet J, Lepape A, Balayn D, Seguin S, Mimoz O. Comparison of Four Skin Preparation Strategies to Prevent Catheter-related Infection in Intensive Care Unit: a Study Protocol for a Randomized Controlled Trial. Tri j. 2013; 11(1):101-20.
  12. Asgari M, Solamani M.Special Nursing Care of CCU.ICU.Dialysis. 4nd ed. Tehran: Boshra: 1390:300.400. (Persian)
  13. Dumyati G, Concannon C, van Wijngaarden E, Love TM, Graman P, Pettis AM, et al. Sustained Reduction of Central Line Associated Bloodstream Infections Outside the Intensive Care Unit with a Multimodal Intervention Focusing on Central Line Maintenance. Amer J inf cont. 2014;3(7):410-20.
  14. Zinn J, sford V .Intraoperative Patient Skin Prep Agents. Am J Kidney Dis. 2010; 12(7):13-22.
  15. National Kidney Foundation. KDOQI Clinical Practice Guidelines and Clinical Practice Recommendations for 2006 Updates: Hemodialysis Adequacy, Peritoneal Dialysis Adequacy and Vascular Access. Am J Kidney. 2006; 16(6):212-18.
  16. Born S.Guide to the Elimination of Infections in Hemodialysis CDC and Recommendations for Preventing Transmission of Infections among Chronic Hemodialysis Patients. MMWR J.2010:11(1); 50(5):50-60.
  17. Ghodosi A, Iranian GH. Cansider in Operation Scrab Medical University of Ilam. MCR J Infect. 2008; 3(2):17-21. (Persian)
  18. Taghinejad H, Asadizaker M, Tabesh H. A  Comparative  Analysis  of    the  Effects  of  Betadine and  Alcohol  as  Sterilizers on the Complications of  Intravenous Catheters.  J ILA Uni Med Sci. 2008; 13(4):10-16. (Persian)
  19. Adib.hajbagheri M, Molavizadeh N, Alavi NM, Abadi MHM. Factors Associated with Complications of Vascular Access Site in Hemodialysis Patients in Isfahan Aliasghar Hospital. Ira J nurs. 2014; 19(2):208-18. (Persian)
  20. Frasca D, Dahyot-Fizelier C, Mimoz O. Prevention of Central Venous Catheter Related Infection in the Intensive Care Unit. Crit Care. 2010; 14(3):212-24.
  21. Brunicardi F, Sangsuksawang N. A Randomized Controlled Trial of 1% Aqueous Chlorhexidine Gluconate Compared with 10% povidone.iodine Alcoholic for Topical Antiseptic in Surgery: effects on blood culture contamination rates. Infec Cont Epid. 2013; 34(4):430.2.
  22. Kulkarni AP, Awode RM. A Prospective Randomised Trial to Compare the Efficacy of Povidone.iodine 10% and Chlorhexidine 2% for Skin Disinfection. Ind j ana. 2013; 57(3):270-9.
  23. Nuntnarumit P, Sangsuksawang N. A Randomized Controlled Trial of 1% Aqueous Chlorhexidine Gluconate Compared with 10% Povidone.iodine for Topical Antiseptic in Neonates: Effects on Blood Culture Contamination Rates. Infection Control and Hospital Epidemiology. 2013; 34(4):430-2.
  24. Timsit JF, Mimoz O, Mourvillier B, Souweine B, Garrouste.Orgeas M, Alfandari S, et al. Randomized Controlled Trial of Chlorhexidine Dressing and Highly Adhesive Dressing for Preventing Catheter.Related Infections in Critically Ill  Adults. J cri care med. 2012; 186(12):1272-8.