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This study investigated the types of skin antiseptic solution used for vascular access (VA) in hemodialysis patients and the reasons for selection. Seven hundred health-care facilities were randomly selected from the total of 3,827 hemodialysis centers in Japan, and a self-completed questionnaire was mailed to the chief nurses of the selected health-care facilities to conduct an anonymous survey. Three hundred and twenty-six facilities returned the questionnaires (46.5 response rate), and the answers from 323 facilities were analyzed (99.1). Usage of ethanol was high in patients with arteriovenous ˆstulas (38.1), and povidone-iodine was used for many cases of all VA types except arteriovenous ˆstulas (arteriovenous grafts 74.8; superˆcial arteries 72.1; short-term VA catheters 72.0; long-term VA catheters 65.8). Usage of chlorhexidine gluconate-ethanol was 18.4 for short-term VA catheters and 21.8 for long-term VA catheters. In a few cases, weakly and strongly acidic water were used for arteriovenous ˆstulas, physiological saline (normal saline) for short-term VA catheters, and physiological saline (normal saline) or tap water for longterm VA catheters. The reason for choosing the antiseptic solution was signiˆcantly related to the ˆrst choice of antiseptic solution for all ˆve VA types. Knowledge regarding the skin antiseptic solutions in the Centers for Disease Control and Prevention guidelines was signiˆcantly related to the ˆrst choice of antiseptic solution for shortand long-term VA catheters. This study found many types of skin antiseptic solutions were used for all ˆve VA types. More solid evidence for correct selection of the optimum skin antiseptic solutions for each of the VA types is needed. Key wordshemodialysis, vascular access, antiseptic solution

Survey of Skin Antiseptic Solutions for Vascular Access in Hemodialysis Patients in Japan: Types and Reasons for Selection