When connecting drain tubing to the PD catheter with a povidone iodine cap, is it necessary to soak the catheter connection or tip in antiseptic prior to connecting the tubing? Or is a no touch technique superior when the catheter has an antiseptic soaked cap? The latest Lippincott procedure instructs to soak the catheter tip in an antiseptic soaked gauze for 5 minutes before connecting the tubing. I understand cleaning the catheter with the cap still on prior to removing the cap and connecting to the tubing, but I can't find any rationale for doing this extra step of soaking the catheter tip.

Questions About PD

Angela N, Nurse from St. Louis, MO asked
When connecting drain tubing to the PD catheter with a povidone iodine cap, is it necessary to soak the catheter connection or tip in antiseptic prior to connecting the tubing? Or is a no touch technique superior when the catheter has an antiseptic soaked cap? The latest Lippincott procedure instructs to soak the catheter tip in an antiseptic soaked gauze for 5 minutes before connecting the tubing. I understand cleaning the catheter with the cap still on prior to removing the cap and connecting to the tubing, but I can't find any rationale for doing this extra step of soaking the catheter tip.

1 answer

Nurse Canada with members of the ISPD Nursing Liaison Committee April 15, 2021

We thank you for your question. We have to presume your question relates to the steps when commencing a CAPD exchange, with drain being the first part, then fill. We conducted an informal survey of members from different countries (Brazil, Canada, New Zealand/Australia, the UK and the US) of the ISPD Allied Nursing Committee. For most of these countries it is not common practice to soak the transfer set connection tip with an antiseptic soaked gauze for 5 minutes before connecting the CAPD tubing, neither is it common practice to clean the catheter cap prior to removing it (1,2). We do teach our patients on PD to use aseptic non-touch technique when performing a CAPD exchange (1,2). Some units in the United States do teach patients to clean the catheter cap (MiniCap containing povidone-iodine) prior to removing it for a CAPD exchange.
 
Now, we would like to point out that we are discussing here the procedure taught to patients learning CAPD who are going to be performing CAPD exchanges 4 or 5 times a day at home as prescribed by their nephrologist. The procedure for changing the PD catheter transfer set is quite different: usually undertaken once every few months, following the policy of the PD unit; and, performed by the PD nurse for the patient on PD during one of the routine PD clinic visits. It is possible you are mixing up the instructions for changing the PD catheter transfer set with those for a CAPD exchange.
 

  1. British Columbia Renal Agency (May 2020). PD Procedures: Performing a Twin Bag Exchange. Available at: http://www.bcrenal.ca/resource-gallery/Documents/RR_PD-Performing_a_Twin_Bag_Exchange.pdf

 

  1. Nova Scotia Health Authority (March 2017). Patient and Family Guide: How to do a Twin Bag™ Exchange. Available at: http://www.nshealth.ca/sites/nshealth.ca/files/patientinformation/0633.pdf

 

#1

Please login to submit an answer