IV site dressing - page 2

Hello, all - I need advice from some IV gurus out there. I was trained that all IV sticks should be dressed with a sterile dressing - with Tegaderm/Opsite being preferred because the site could be easily monitored. In the... Read More

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    This is an old thread that I found while doing a search for IV site dressings. Our protocol is to use the occlusive dsg, however we have a couple of MD's on our unit that go through the roof if they find one on their patient. (My understanding is that they were seeing damage to patients' skin when the dsg was removed. I work on an internal medicine unit. Our patients have chronic illnesses, most are elderly, and most have thin/compromised skin.) The result is that our clinical coordinator uses a combination of cottonball with bandaid and or papertape to dress the IV site. The other nurses on the unit either put occlusive dsgs on everyone and to **** with the MD...or they use cottonball/tape/bandaid on everyone. The administration appears to ignore our unit when it comes enforcing IV dsg protocol. So here are my questions:

    1. Legally, won't I be held to what is in writing rather than what is in practice on my unit?

    2. Is there a trick for removing the occlusive dsg that is placed on fragile skin so that damage isn't an issue?

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  2. 0
    Quote from Nitengale326
    I work post surgical and our policy is cover with tegaderm. HOWEVER, we are forever getting patients up from OR or ER that have a 1/2 pound of tape and no tegaderm. The surgeons will rant and fuss if they see an IV on the floor with just tape but are blind to it in the OR. Our Clin Spec states our policy book is based on Nursing Standards. You might want to investigate that route and present that to the powers that be to get the policy changed. Remind them too that Tegaderm is a billable good where as tape is not.... Can you say KACHING??? (LOL)

    You can also remind them that the cost of tegaderm is MUCh less than the cost of a lawsuit for pericarditis from an infected IV.
  3. 0
    Quote from veegeern
    1. Legally, won't I be held to what is in writing rather than what is in practice on my unit?

    2. Is there a trick for removing the occlusive dsg that is placed on fragile skin so that damage isn't an issue?

    To answer your first question - yes, if there was ever a lawsuit that involved an infection with the IV as a possible cause, anyone who wasn't following your facility policy relating to IV starts and dressing is vulnerable in that suit. Your facilities policies and procedures are there to protect you as well as the patient.

    To answer your second question - tegaderm is actually not very damaging to skin and not too hard to remove. If I have someone who says they have sensitive skin I will use Cavilon skin prep (comes in little packets like alcohol wipes) under the dressing, and if I am having trouble removing it, or the patient says it is painful to remove, then I use adhesive remover. What is more damaging to skin is tape - and paper tape is some of the worst. After 24 hours it almost bonds with the skin. It is good for people with allergies, but not with fragile skin. We just started using a new tape, and I can't remember what it's called - I'll look tommorow. We did extensive research and trial to find this tape though.
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    Tegaderm also provides visabilty

    And reinforce with tape.
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    Veegee, this is a very old thread, but I do hope you get this reply to your question about the best way to remove a tegaderm without causing a skin tear in elderly patients.

    The best way to do this is to pull the dressing laterally first, which causes it to release, then just pull it off. When you pull it to the side, it will unstick slowly, but it will come loose without damage.

    Good luck!
    threebrats46 likes this.
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    NO way to just tape!! We put tegaderms and have IV start kits and we use statlocks as well. I still see nurses putting just tape and I always change that dressing. If I were a patient I wouldnt want just a piece of tape on me.


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