Catheter port cleansing techniques and the entry of povidone-iodine into the epidural space.

PURPOSE/OBJECTIVES: To determine whether three epidural catheter port cleansing techniques used to apply a povidone-iodine solution differed with respect to the introduction of this solution through the epidural catheter.

DESIGN

Experimental.

SETTING

Laboratory.

SAMPLE

Five DuPen (Davol, Cranston, RI) epidural catheters.

METHODS

Five DuPen epidural catheters each were cleansed twice with (a) a commercially available 10% povidone-iodine swabstick, (b) a commercially available pledget impregnated with 10% povidone-iodine, and (c) a gauze pad saturated with 10% povidone-iodine. The order of cleansing was randomized. Each solution was used to clean the port for 30 seconds, and the port was allowed to dry for 30 seconds, similar to the technique used in the clinical setting. After cleaning the catheter port, water was injected through the catheter, and the solution from the tip of the catheter was analyzed using absorbance spectrophotometry.

MAIN RESEARCH VARIABLES

Cleansing techniques, presence of povidone-iodine in catheter.

FINDINGS

A statistically significant difference existed between the three cleansing techniques, with the pledget yielding the lowest values of povidone-iodine contamination of the epidural catheter (Freidman test, p = 0.02).

CONCLUSIONS

Use of pledgets allowed the least amount of povidone-iodine to enter the epidural catheter as compared with the swabsticks or gauze pads.

IMPLICATIONS FOR NURSING PRACTICE

Commercially available pledgets used to cleanse catheter injection ports may limit the introduction of 10% povidone-iodine into the epidural or intrathecal space.