Comparison of the Effects of 5%NaHCO3, 2%CHG and 70%Alcohol in the Prevention of Infections Related to Catheter

Study Overview
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Brief Summary
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Intravenous catheters have become one of the indispensable tools of modern medicine. Peripheric intravenous catheters facilitate the work of healthcare professionals in the treatment phase, especially in diagnostic procedures. Intravenous catheters cause microorganisms to enter the bloodstream by damaging the skin, which is the body's first defense barrier. In this case, it causes infections, sepsis, an increase in mortality and morbidity rates, prolongation of hospital stay, increase in antibiotic use, and medical expenses. The density of the skin flora in the area where the catheter will be inserted is a major risk factor for infection.To prevent complications associated with peripheric intravenous catheters; Performing the procedure in line with the principles of surgical asepsis and following the correct follow-up are among the most important measures that the nurse should take. Also, the child and the parents should be prepared for the procedure and the appropriate environment should be provided. Along with correct catheter placement and care, antisepsis of the cannula placement area is among the indicators of nursing care. As well as the effectiveness and safety of skin disinfectants, topical absorption, lack of toxic effect, local and irritation effect are also important. Solutions with 5% NaHCO3 have recently come to the fore as antiseptic agents. When the literature is examined, it has not been found that there are very few studies on this solution and it is used in skin antisepsis before peripheral intravenous catheterization in children. This study was planned as a randomized controlled experimental design to determine the effectiveness of 5% NaHCO3 water solution in catheter site cleaning in pediatric patients by comparing it with the most commonly used antiseptic agents and to monitor the development of catheter-related infections.

Detailed Description
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Intravenous therapy is one of the basic elements of modern health care. IV routes provided through catheters for pediatric patients are necessary for primary and secondary health and increase the possibility of mortality and morbidity depending on the treatment given and the factors of the patient. As in every invasive application, there are problems regarding the use of catheters, which is a minimal surgical procedure, and perhaps the most important of these is catheter-related infections. CRI's are defined as the accompanying of both local (redness around the catheter, increased temperature, discharge, drainage, tenderness, edema) and systemic (fever, chills, changes in laboratory tests) infection findings in patients and is an important complication for children. is happening. The increase in prevalence varies among patients, as well as between cities and countries, and is among the top three among hospital-associated infections. Although there are many studies on infections related to the use of a peripheric intravenous catheters in adult patients, it is reported that this issue is not addressed much in children. It is thought that there is no standardization regarding peripheric intravenous catheters management in the studies conducted. Since the risk factors for infection such as body weight, concomitant chronic disease, characteristics of the catheter used and the drug administered, presence of interconnection for pediatric patients are different from adults, catheter-related infections in the pediatric age group requires a separate discussion. It cannot be denied that the main step in the prevention of catheter-related infections is the management of peripheric intravenous catheters and determining an appropriate skin antiseptic is a part of this. In Children, 70% Alcohol, 2% Chlorhexidine Gluconate, 1% Octenidine, and 10% Povidone-iodine type antiseptics are commonly used for skin antisepsis. Sodium bicarbonate (NaHCO3) solutions are used in different areas such as oral hygiene and dental care in the world and our country, and side effects are not reported. There is limited information in the literature regarding its use as a skin antiseptic, and it is seen that this information belongs to the adult age group. There is no data on the child age group. In this study, which was planned in two stages to determine the effectiveness of the use of sodium bicarbonate as a skin antiseptic in the prevention of catheter-related infections, the effectiveness of the antiseptics used in the first stage was evaluated in the laboratory environment against the most common microorganisms in the skin flora, and in the second stage, the use of these antiseptic solutions in skin cleansing in pediatric patients before the peripheric intravenous catheters procedure their effectiveness has been evaluated.

Official Title
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Comparison of the Effects of 5% NaHCO3, 2% Chlorhexidine Gluconate and 70% Alcohol for Prevention of Infections Related to Catheter Applications in Children.

Conditions
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Disinfectant Dye Adverse Reaction, Catheter-Related Infections, Nursing Caries, Children, Only, Skin Lesion, Chlorhexidine Adverse Reaction, Catheter

Intervention / Treatment
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* Drug: Skin antisepsis with 5% NaHCO3 water solution
* Drug: Skin antisepsis with 2% Chlorhexidine Gluconate solution


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Being between the ages of 1-18 Having inpatient treatment in pediatric clinics No previous history of catheter-related infections No history of systemic infection Absence of immunological disease Not using antibiotherapy No scar/scar tissue on the skin in the catheterization area Exclusion Criteria: Being an inpatient who does not need intravenous treatment Finding an infection Having a chronic skin disease Having a history of allergies Being a newborn

Ages Eligible for Study
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Minimum Age: 1 Year
Maximum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Single blind Randomized controlled Experimental
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Experimental Group 1<br>Cleansing the skin with an antiseptic solution before intravenous catheterization Skin antisepsis with 5% NaHCO3 water solution group Grup number: 20 | Drug: Skin antisepsis with 5% NaHCO3 water solution<br>* In-vitro analysis of the solutions was done first. Then solutions were applied, and peripheric intravenous catheter was installed<br>* Other names: Chemical substance;|
| Experimental: Experimental Group 2<br>Cleansing the skin with an antiseptic solution before intravenous catheterization Skin antisepsis with 2% Chlorhexidine Gluconate solution group Grup number: 21 | Drug: Skin antisepsis with 2% Chlorhexidine Gluconate solution<br>* In-vitro analysis of the solutions was done first. Then solutions were applied, and peripheric intravenous catheter was installed<br>* Other names: Chemical substance;|
| No Intervention: Control Group<br>Cleansing the skin with an antiseptic solution before intravenous catheterization Skin antisepsis with 70% Alcohol solution group Grup number: 21 | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The effectiveness of the solutions - In-vitro analysis | Effectiveness in the laboratory: The efficacy of the solutions on the most common bacteria on the skin was tested in the laboratory. Analysis of solutions to be used in Laboratory Environment (In vitro): 5% NaHCO3 water solution, 2% KHG solution and 70% Alcohol solution to be used in the catheterization process were studied in the laboratory with the microbiologist in the blood, Müller Hinton agar with disk diffusion method. The diameter of the discs used is 9 mm. Microorganisms are clinical isolates. As a result, they are the inhibition zones recorded. | One months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The effectiveness of the solutions - Practice | Before the process, the solutions were prepared by the researcher weekly in the laboratory. The solution to be administered to the patients was determined by randomization. In the units where the study was conducted, peripheral intravenous catheters were placed in the hospitalized patients who met the inclusion criteria for their routine treatment. Before the procedure, the skin of the catheter insertion site was cleaned with an appropriate antiseptic solution according to the randomization groups. After skin cleansing, a catheter was inserted. The inserted catheters were fixed with a transparent catheter fixing tape. The introductory information section on the patient in the data collection form was filled in before the procedure, information on catheterization and catheter infection follow-up sections after the insertion of the peripheric intravenous catheter. | Five months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Antiseptic, Intravenous catheterization, Catheter-related infection, Chlorhexidine gluconate, Sodium bicarbonate