Ask HRC: Including Chlorhexidine in Prep Kits

An ECRI Institute member hospital recently wrote asking for advice in responding to a group of nurses who requested that all of the hospital’s prep kits—including surgical, intravenous (IV), and peripherally inserted central catheter (PICC) kits—be changed to include chlorhexidine as the solution. The member noted that this was the first time she had received such a request, and that the requested change would result in a cost increase of more than 50%.

In our response, HRCsupports the nurses’ request to switch to chlorhexidine in IV prep kits. Studies of intravascular catheter-related bloodstream infections that control for the underlying severity of illness suggest an attributable mortality rate for these infections is between 4% and 20%. Thus, it is estimated that between 500 and 4,000 patients in the U.S. die annually due to bloodstream infections (Mermel). Healthcare-associated bloodstream infections prolong hospitalization by a mean of seven days. Estimates of attributable cost per bloodstream infection are estimated...