Evidence Based Care

Evidence Based Care

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
Javad Malekzadeh 1
Hasan Forouzanfar 2
Seyd reza Mazluom 3
Fatemeh Nazemian 4
Ali Bazzi 2
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
10.22038/ebcj.2014.3652
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.
Keywords
Povidone-iodine
Inflammation advent
Vascular Access devices
hemodialysis
Soaps
Infection
Subjects
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