Bio Patch with PICC line dressing changes?
- 0Apr 23, '13 by nervousnurseHi, 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?
Where I'm working, we don't deal with PICCs often, so that's another reason I want to ask. At my previous, we ALWAYS used the biopatch, but now, we're only using the regular dressing kit, which contains the spongy chlorhexadine thingee to cleanse the insertion site.
I was reading on a PICC Nursing site about the biopatch, and it seems as though it is still used a lot. I suggested it to my boss and am awaiting her response.
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- 0Apr 23, '13 by blondy2061hOur policy is the same whether it's a PICC, CVL, or IVAD. We use biopatches. The kits have 2 masks (patient and nurse), sterile gloves, a tegaderm dressing, two chg swabs, one skin protectant swab, a gauze (for if the site is fresh and bleeding is an issue), and a small sterile drape, which I never use.
- 0Apr 23, '13 by sbostonRNOur dialysis nurses (in-house) use biopatches on their HD catheter sites, but we do not use them on regular accessed PICC or central lines. Our kit includes one mask, sterile gloves, alcohol swab, chlorhexidine sponge, and Tegaderm dressing. We also don't use a securement device as the dressing itself secures the catheter.
- 0Apr 23, '13 by TheCommuter Senior ModeratorAt my place of employment the policy is to apply biopatches with each PICC line, midline, or other type of central line dressing change.
Floor nurses do not deal with dialysis perma-caths because they are accessed and dressed during outpatient dialysis appointments.
- 2Apr 24, '13 by iluvivt
It helps to look at the current recommendations and then try and interpret them based on all the evidence you can find. These are from the CDC Guidelines to prevent catheter related blood stream infections ..keep in mind they do not endorse any particular product nor do INS guidelines but the biopatch is an impregnated sponge dressing
Use a chlorhexidine
impregnated sponge dressing for
term catheters in
patients older than 2 months of age if the CLABSI rate is not decreasing despite
adherence to basic prevention measures, including education and training, appropriate
use of chlorhexidine for skin antisepsis, and MSB [93,
98]. Category 1B
No recommendation is made for other types of chlorhexidine dressings. Unresolved issue
Clearly, when you read all the evidence it is evident that CHG cannot transfer, suppress colonization, and subsequently decrease risk where it is not in contact with the skin. Biopatch is effective because it does make this contact when you compare it to competitors. Circumferential protection at the insertion site is a superior design without gaps in coverage and thus efficiency . Keep in mind that this only addresses extraluminal sources of infection and not the extraluminal sources.
Since there is no longer any reimbursement as of Oct 2008 for hospital acquired CRBSI I believe that the goal should be a BIG zero as a goal for CRBSI and you should do everything in your power to prevent it. That requires excellent insertion and care and use practices,