I am reviewing the current AACN guidelines for PD for my hospital. They are stating that appropriate exchange procedure per current literature includes: Scrubbing the area from the catheter cap to the twist/roller clamp with antiseptic soaked gauze. (This is when a healthcare professional is performing the exchange.). IS this what you recommend? I do not see hospital procedure recommendations on your website.

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I am reviewing the current AACN guidelines for PD for my hospital. They are stating that appropriate exchange procedure per current literature includes: Scrubbing the area from the catheter cap to the twist/roller clamp with antiseptic soaked gauze. (This is when a healthcare professional is performing the exchange.). IS this what you recommend? I do not see hospital procedure recommendations on your website.

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Nurse Canada August 31, 2018

We thank you for your interesting question. Your question concerns the recommendation that the procedure for a PD bag exchange in the current American Association of Critical Care Nurses (AACN) text book “AACN Procedure Manual for High Acuity, Progressive and Critical Care” includes the added step of “scrubbing the area from the catheter cap to the twist/roller clamp with antiseptic-soaked gauze”. In Canada, for home PD patients in their homes or when admitted to hospital, to the best of my knowledge, we do not follow this added step and never have done. My understanding is that some PD units in the United States have recently started to teach their home PD patients to include this added step in the PD exchange procedure, but not all PD units do. I was not able to find any research studies published in peer-reviewed medical or nursing journals supporting this practice. Another concern is that It is possible that through this “scrubbing” of the PD catheter close to the PD catheter cap, a patient could inadvertently dislodge the cap and introduce an infection.

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