Infection precautions with temporary pacing leads: A descriptive study

OBJECTIVE: To describe infection precautions used by nurses when caring for patients with temporary epicardial and transvenous pacemakers. DESIGN: Descriptive, nation-wide survey. SETTING: All U.S. hospitals performing cardiac surgery. RESPONDENTS: Nurse managers and clinical specialists from cardiac and thoracic intensive care, coronary care, and telemetry units at all U.S. hospitals performing cardiac surgery. INTERVENTION: Responses came from 43% (388) of the 895 hospitals. Most respondents indicated that they wore gloves when handling electrodes (approximately 96%); usually the gloves were nonsterile (73%). A sterile procedure was often used to perform site care (37% for epicardial and 65% for transvenous). The most common agent used for site cleansing was povidone-iodine. Concern has been expressed in the literature about use of this agent. Gauze was the most common type of dressing (used by 60% for epicardial dressing and 31% for transvenous). CONCLUSIONS: There is diversity in clinical practice. Further study is recommended to establish the safety, efficacy, and cost-effectiveness of identified infection precautions.