by myita32

Hello all-

My unit is having a high incident of pressure ulcers (PU) these days . Part of it is related to the instability of our patient population (ECLS, VAD, open chests, etc.). Upon audits on the types of PU we are noticing an increase in small PU near NGT/FT securement sites. With that being said, I wanted to see if anyone had some ideas or current practices in use that maintain patient skin integrity, but also keep these tubes secure. What is your current protocol for frequency of retaping the site? We have an esophagectomy population as well that have strict post-op instructions for no NGT manipulation. Although I think we are finding these PU on more of our long term patients.

I also wanted to see what other ICU/CCU current practice is with turning patients as far as scheduling, assistance, etc. We currently have 1 PCA/CNA per shift for a 16 bed unit and Ihiring another PCA/CNA is not an option. Has anyone had experience with a turning schedule or something to that affect?

Any input would be so greatly appreciated!

Thank

Re: NGT/FT securing techniques?

I like to secure tubes in two ways...#1...tape the tube to the ETT allowing no pressure on the nare. #2....tegaderm with benzoine...you can the the tube secured without any pressure on the nare. I also like the tegaderm because you can see what is going on. I've also had good luck using steri-strips, although the adhesive can be pretty rough...

Re: NGT/FT securing techniques?

We have a special NG securement device that we use. It is a sort-of diamond-shaped piece of duoderm with a little clamp on the end that looks like a tiny plastic handcuff. Duoderm on the nose with the clamp hanging off the end to secure the NG. I love them. They stick better/longer than silk tape, but they don't damage the skin coming off. You can also see the numbers on the tube, so you know exactly what cm-mark your insertion point is. Sorry I can't remember who makes them.

Re: NGT/FT securing techniques?

Is this it? Hollister makes it. Sure do wish we had those! I'll put the recommendation in.

Re: NGT/FT securing techniques?

I've tried these little gadgets and...well...I have had no luck getting them to work. They never stick and they are uncomfortable for the pt.

Re: NGT/FT securing techniques?

Originally Posted by Angie O'Plasty, RN

Is this it? Hollister makes it. Sure do wish we had those! I'll put the recommendation in.

That's it! I really like them. I think they stay on better than silk tape, esp to oily skin, and they are a heck of a lot easier to put on.

Too bad they don't make StatLock's for NG's yet! I love StatLock's for IV's, and I hear (but have not had the opportunity to see/try) they make a similar device for Foleys.

Re: NGT/FT securing techniques?

We use stat-locks.. They work great and stick well-until they don't. It's great because after a few days, they lose stickiness and then we can rotate the site.

Re: NGT/FT securing techniques?

tegaderm and benzoine on the cheek works best for me. i've also found that after the commercial strips have lost their stickiness, small strips of silk tape stick like they never have before! We don't have CNAs either, but we still turn our pts every 2 hours on the dot. then we go and complain to the boss about how much our backs hurt! hasn't worked yet. :P i use other nurses, our RTs, the x-ray techs when their around, families, or anyone else i can get to help me.
:P

Re: NGT/FT securing techniques?

what about doing and OGT instead of a NGT? obviously only on pt's with ETT's, but they are really easy to put in if you guide it right along next to the ETT...and just secure it to the ETT as well.