BIOPATCH

[lbeauplan]

We used to applied BIOPATCH on Central Line dressing and Change transparent dressings at least every seven days and PRN for infection prevention. After months of using it was discovered that it was not that effective, therefore it was discontinued.

Is there anyone who works in a hospital setting who is currently using a effective product?

[NotReady4PrimeTime, RN]

There's a very timely article in the November issue of the American Journal of Critical Care on just this subject. The study discussed in the article was done in a PICU but the results should not be considered invalid in adults. Their study suggests that the CVL dressing change process is more important in preventing CRBSI than the products used in the dressing change. http://www.nxtbook.com/nxtbooks/aacn/ajcc_200911/#/20/OnePage

When our unit first began using BIOPATCH the supply we received was white on both sides. It was difficult to decide which side went up when dressing a CVL on a squirming toddler and our administration had issued a directive that we were only to use them on femorally-placed arterial lines because all of the CVLs we used were antibiotic-impregnated and didn't need them. So we didn't use them much and we still don't.

[ebeehm]

Thanks for sharing! Looks like it's an observational study and not a randomized controlled trial, comparing only 18 patients to 21 patients. Hardly an indictment or an endorsement one way or the other! This is a good read because the authors openly acknowledge the limitations of their study and use it as a catalyst for discussion around practices vs. technology which is a discussion that needs to be had since it really should not be a question of "OR". In my opinion, line care or otherwise, it should be about best practices AND technology, both of which should be determined through rigorous evidence and science, not through marketing and sales practices by industry and not through anecdotes!

[Music in My Heart]

Our regional medical center found that their rates of cath-related infections dropped substantially when they went to dedicated teams changing PICC dressings. The problem is that now the floor nurses think that they can't change a nasty dressing and will just leave it be until the PICC team gets to it. Their goal is q72 changes by the PICC nurses and prompt PRN changes by the floor nurses.

[jmalouf]

I'm new to this forum, but I've enjoyed reading the posts. Our home health agency has been doing sterile PICC dressing changes using tegaderm and a biopatch every 7 days. However, the recent National Home Health conference in Los Angeles said "best practice" is to use a biopatch only for the first 7 days after insertion. Long term PICC care should involve sterile chloraprep/tegaderm dressing changes with no biopatch. Not using a biopatch allows for better insertion site visualization.

So, we are considering a change in our policy to reflect "best practice", but I'm struggling to find real research to back it up.

Any help?

[ebeehm]

I'm new to this forum, but I've enjoyed reading the posts. Our home health agency has been doing sterile PICC dressing changes using tegaderm and a biopatch every 7 days. However, the recent National Home Health conference in Los Angeles said "best practice" is to use a biopatch only for the first 7 days after insertion. Long term PICC care should involve sterile chloraprep/tegaderm dressing changes with no biopatch. Not using a biopatch allows for better insertion site visualization.

So, we are considering a change in our policy to reflect "best practice", but I'm struggling to find real research to back it up.

Any help?

The CDC just published a draft of its updated guidelines for prevention of catheter-related infections. Best practices specific to the biopatch are addressed:

http://www.cdc.gov/ncpdcid/pdf/Draft_BSI_guideline_v15_2FR.pdf

[SusanDeSmet]

We currently use Biopatch for our PICC and Midline catheters. Does anyone use it on the Huber needles for Infusaports? Any info about best practice for ports??

[blondy2061h, MSN, RN]

We currently use Biopatch for our PICC and Midline catheters. Does anyone use it on the Huber needles for Infusaports? Any info about best practice for ports??

We have special miniature biopatches that go around the huber needle prior to insertion into the IVAD and stay there for the duration of the needle placement.

[dudette10, MSN, RN]

If you place the biopatch correctly, it prevents infection. If you don't place the biopatch correctly, well, all bets are off. Hard to believe that people would bail out on a product that is clinically proven because "people aren't using it right". None of the other products mentioned in this discussion are proven to prevent catheter infections or are researched in how they perform. Their comparison to biopatch has no clinical or relevant basis. Just read the literature these sales reps give you, don't just listen to their sales pitches.

Since the manufacturer added the word UP to the blue side of the biopatch (duh) I haven't seen any upside down ones on our unit.

I know this quote is an old one, but frequency of incorrect use/application due to product design is indeed a valid reason to discontinue using a product until it or the packaging is redesigned. If another product swoops in that decreases incorrect use and has the same outcome, well, that's capitalism.

[sistrmoon, BSN, RN]

We use bio patches on our ports. All central lines have them.

[emtb2rn, BSN, RN, EMT-B]

We use bio patches on our ports. All central lines have them.

Same at my hospital.

[ChipNurse]

We use the biopatch and we have had 0% infection rates for months. We routinely change the dressings every week, or as needed if the patch is visibly soiled. It is done as a sterile procedure with mask and sterile gloves. I agree with others that the biopatch has to on correctly. I have seen too many times the patch laying on top of the catheter. We also do chlorahexadine bath wipes every day for people with central lines.

[ahirosky]

Would any of you be able to provide your knowledge or policy on the need or not for a prescription for using a Biopatch. I am looking for some type of documentation to support. The current understanding where I work is that we cannot use the Biopatch unless we have a script for it. Is this correct?