Comparison of the effect of rinsing the vascular access site for hemodialysis with Betadine scrub and soap by patient on the frequency and onset of local inflammation and infection

Document Type : Original Quantitative and Qualitative Research Paper

Authors

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

2 MS in 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

4 Associate professor of Nefrology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

Abstract

Background: Despite the implementation of nursing measures in disinfecting the ​​vascular access site for hemodialysis, this area is responsible for 23 to 73 percent of bacteremias occurring in these patients. Participation of the patients in washing this area may be helpful.
Aim: this study was conducted to determine and compare the effect of washing vascular access site for hemodialysis with betadine scrub and soap by patient on the frequency and time of appearance of the inflammation and infection.
Methods: The study was conducted on 62 volunteers in hemodialysis center of Mashhad city. Patients were randomly divided into two groups, betadine and soap. Before starting dialysis, the vascular access site was washed with either betadine by the betadine group or soap by the soap group. Assessments for inflammation in the vascular access site were performed using the inflammation-scale of "Association of intravenous injection" and the infections were monitored by culturing the secretions of the area over one month. Data were collected using a measure of inflammation by the “Association of intravenous injection”. Results were analyzed by chi-square and independent T tests, and survival was analyzed using SPSS version 11.5.
Results: before the intervention, the two groups were similar regarding variables such as age, sex, blood sugar, vascular access, and marital status. The incidence of inflammation was 96.7% in soap group and 53.1% in betadine group during one month (p < 0.001). The onset of inflammation in the betadine group (4.8±2.3 sessions) was longer than the soap group (4.5±3.2sessions), but this was not significant (p= 0.060).
Conclusion: Participation of the patients in washing the vascular access site especially with Betadine solution, in addition to the usual disinfection by nurses can reduce the incidence of inflammation. Further study into the delaying effect washing on the onset of inflammation is required.

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  1. Maslom S, Tanha HER, Dalir z, Sharifipour F, Zerati A. Effect of Ice Chips on Intensity of Thirst and Fluid Intake in Patients Undergoing Hemodialysis. EBC. 2013;3(3):59-68.
  2. Fauci AS. Harrison's Principles of Internal Medicine: McGraw-Hill Medical New York; 2008.
  3. John T, Daugirdas, Peter G, Blake, Todd S. Handbook of Dialysis. 3 ed2008.
  4. Khavaninzade M, Omrani Z, Shirali A, Najafi N. Determine the Incidence and Survival of Vascular Access Procedures in Patients With End-Stage Renal Disease (ESRD) Undergoing Chronic Hemodialysis in Tehran in 1384. IJMS. 1387;15(60):71-7.
  5. Amouyi A, Zare M. Survival of Arteriovenous Fistula in Hemodialysis Patients in Yazd Shahid Rahnemoun Hospital. HMJ. 2005;9(2):85-92.
  6. Schwab SJ. Up to Date. Thrombotic Complications of Chronic Hemodialysis Vascular Access: Fistula and Graft. 14.3, editor2006.
  7. Derakhshanfar A, gholyaf M, Niayesh A, Bahiraii S.  Assessment of Frequency of Complications o Arteriovenous Fistula in Patients on Dialysis. SJKDT. 2009;20(5):872-5.
  8. Adib-Hajbagheri M, Molavizade M. Study of the Quality of Vascular Access Care Among Hemodialysis Patients. IJCCN. 2011;4(2):87-92.
  9. Rutherford, Robert B. Vascular Surgery. 6 ed2005. 117-20 p.
  10. Akbari H, Raufi S, po DH, Anbari K. Comparaing the Effect of Nitroglycerin and Clobetazol Ointments on Prevention of Superficial Intravenous Catheter Induced Phlebitis. EBC. 2014;4(1):71-80.
  11. NF P. Operative Surgery Principle and Technique. 6 ed: w.b Saunders company 2006.
  12. Sanaie N, et a. The Effect of Family-Centered Empowerment in  Self Efficacy and Self Esteem in Patients Undergoing Coronary Bypass Graft Surgery. Journal of Research Development in Nursing& Midwifery 53. 2013;11(2).
  13. Baljani E, Rahimi J, Amanpour E, Salimi S, Parkhashjou M. Improve Efficacy and Reduce the Impact of Nursing Interventions on Vascular Risk Factors in Patients With Cardiovascular Disease. Journal of Nursing and Midwifery, Tehran University of Medical Sciences. 1390;17(1):45-54.
  14. Ashktorab T, Solimanian T, Borzabadi Z, Alavi Majd H, Samini M. Effects of Skin Disinfection by Alcohol and Chlorhexidine on Catheter-Related Phlebitis. SID. 1385;16(53):40-7.
  15. Assadi F, Khagehkaramodin M. Evaluation of Skin Preparation Methods in Clean Abdominal Surgery 2003(15).
  16. Taghinejad H, Asadizaker M, Tabesh H. a Comparative  Analysis  of    the  Effects  of  Betadine and  Alcohol  as  Sterilizers on the Complications of  Intravenous Catheters.SJIMU. 2006;13(4):10-6.
  17. Daniela F, all e. Influence of Povidone-Iodine Preoperative Showers on Skin Colonization in Elective Plastic Surgery Procedures. ASPS. 2008.
  18. S; K, A; F. Investigate the Relationship Between Perceived Self-Efficacy and Self-Care Functioning in Patients Diabetes Mellitus in Orumie Diabet Clinic Journal of Nursing and Midwifery, Orumie University of Medical Sciences. 2013;3(10.(