Bio Patch with PICC line dressing changes? - page 2
Hi, I did a search for this topic before posting and the most recent one was 2009----it was interesting that someone posted it was found they weren't effective, whereas others said it is......What's the policy where you work? ... Read More
- 0Apr 24, '13 by NicuGalWe use biopatchon our kiddos that meet criteria. They are looking at dressings that impregnated with gel for our older kids and on the adult floors. All central access lines, except umbilical lines, get a patch unless they have skin issues with it. If we use it on our 1000 gm and feel it doesn't obscure the site then it will be fine on adults we have been over a year without a central line infection
- 0Apr 24, '13 by turnforthenurseRNUsing a Biopatch is policy at my workplace, but it's interesting because our central line dressing kits do not contain them. We have to remember to grab the Biopatch separately. The dressing kits contain 2 sets of masks, sterile gloves, chlorahexadine, skin protectant, tape, a 2x2 (which I don't use) and a clear sterile dressing (Tegaderm).
- 1Apr 24, '13 by SoldierNurse22Quote from NurseDirtyBirdYeah, that is an issue. By the time you have an infection, most of the time, we have to pull the line anyway. A biopatch is WAY too late by then.Our facility policy is actually different. We are not to use a biopatch unless there are s/s infection because of visualization issues. Sounds too late to me, but that's our policy.
I don't mean to knock anyone on this board, but I really don't understand the hospitals with policies that don't require biopatches due to visibility. Biopatches aren't that big and if you're doing a good assessment, you'll catch an infection even with a biopatch in place. If you're that curious about the insertion site due to redness/exudate/pain, do a dressing change and check the insertion site as you would anyway with a patient who is presenting with those s/s. Too easy.
- 1Apr 24, '13 by iluvivtYou are correct it that it is not a big deal to see the insertion site. I just meaured one from the radial slit (the portion of the insertion site you will not see) and its 1 cm. You can use your other assessment parameters such as palpation of the site and along the course of the vein,visualize what you can see,ask the patient if they are having any pain or tenderness at the site,look for s/sx of systemic infection as well. As with any thing in nursing and medicine you need to evaluate the evidence and weigh the risk vs the benefit. The benefit is so great here with almost non-existant risk. The only risk I can see would be if the patient stated they were allergic to it!
- 0Apr 25, '13 by iluvivtYes! I can see that happening but see how you like the CHG pad that is incorporated into the TSM dressing. I would say education is needed or have a dedicated team to perform all CVC dressing changes. The CDC does recommend a dedicated team to perform this function but with everyone having concerns about the changes coming next year with the ACA I can see that may not be happening at some places. I did not like that dressing. It tends to get gummy and we had to pick it off and you can still not center it properly and you lose the benefit of the design of the biopatch that encircles the entire catheter skin junction. Again it is wise to look at all nursing interventions that aid in keeping the infection rate low and possibly to even zero.
- 0Apr 25, '13 by SoldierNurse22We had the same issue with the gel patch being stubborn when trying to remove it. The **** patch will pull at the catheter, the skin, the dressing--it's a mess.
I'll be darned if a (sterile, of course) NS flush dripped over the gel while gently removing from the site doesn't work like a charm.
- 0Apr 25, '13 by FlyingScotNormal saline is what the manufacturer reccommends for dressing removal. Our PICC dressing change kits come with a saline syringe in it. So far I like the gel dressings and have had no problem removing them even without saline. They are much easier to remove than an incorrectly positioned Bio-Patch.