Hi all, I'm new to this site, so please bear with me. I thought I'd ask for some advice or opinions on a situation I encountered involving a PICC dressing change. I'm a fairly new grad working in home health care. It's been tough, but I look up policies and do research often to get through my days. I was also an excellent student so feel I can make it in home health with extra effort at the start. That doesn't come without worrying though, and I've been questioning my abilities as a nurse lately...I had a patient who needed a PICC dressing change. I've done a few awhile back, so felt okay going through with this on my own. However, the only tegaderm available was the smallest size, so when covering the catheter site, I was able to do it with the waterproof dressing, but it wasn't large enough to cover the statlock securement device. So for this, I used sterile gauze and paper tape roll. I mentioned in my documentation that there were no large waterproof dressings available, but am worrying about this. My manager frowned and but didn't seem worried and didn't give me much advice when I told her this after the fact. I'm normally very conscientious and should have sought help right away, but I guess recent fatigue didn't allow to be on my A-game. I'm stressed that the statlock isn't covered with a waterproof barrier, but guaze and tape, and am really kicking myself. Ay, ay, ay. Any thoughts?
Mar 21, '12
First of all tegaderm isn't waterproof and second of all the statlock does not need to be covered. You would need to instruct the client to also cover with some sort of waterproof. Some people use Saran wrap with tape in the home and we also use aqua guards in the hospital.
It gets difficult now since you've put gauze over the statlock. The tape is now probably stuck to the tegaderm and probably all should be changed since that gauze will most likely not be too sanitary, especially if left on like that for a week.
Maybe it's done differently though in the home setting and per region but I would def let your manager know.
Last edit by DookieMeisterRN on Mar 21, '12
Mar 21, '12
by Anna Flaxis
Couldn't you just overlap two of the small tegaderms?
And, not to pick on you, OP, but I'm in agreement that new grads shouldn't be doing home health. I think it's really important to get some acute care experience to develop your assessment skills before going into an area where you're so autonomous and have to make judgment calls out in the field with no support.
Last edit by Anna Flaxis on Mar 21, '12