A comparison of the efficacy of three methods of antecubital fossa skin disinfection prior to phlebotomy in volunteer blood donors

Abstract

Research suggests that many of the contaminating organisms that are responsible for transfusion related morbidity and mortality are components of normal skin flora that enter the blood product during collection at the time of venepuncture. A repeated measures, quasi-experimental design was used to investigate and compare the efficacy of three methods of antecubital fossa skin disinfection used for phlebotomy site preparation in volunteer blood donors. Skin cultures were obtained using sterile Rodac contact plates applied to donors' arms before and after skin disinfection. Skin cleansing was performed using a double scrub no-touch-technique with one of three of the following commercially available antiseptic preparations: (1) a swab scrubstick saturated with povidone-iodine (0.75% titratable iodine) followed by a swab saturated with povidone-iodine (1% titratable iodine) (n = 42); (2) a sponge with 2% chlorhexidine gluconate and 70% isopropyl alcohol followed by an applicator with 2% chlorhexidine gluconate and 70% isopropyl alcohol (n = 42); or (3) a sponge with 70% isopropyl alcohol followed by an applicator with 2% iodine tincture (n = 40). Culture plates were incubated at 35-36 degrees C and colonies counted at 24 and 48 hours pre and post skin disinfection. Statistical analysis using repeated measures ANOVA indicated that there was no statistically significant difference in postdisinfection bacterial colony counts when comparing the effectiveness of the three antiseptic preparations for removing bacterial skin contamination prior to phlebotomy in volunteer blood donors. Recommendations for nursing practice and future research are suggested.