Port-a-cath's and Biopatch usage

[deweydecimal13501]

Hello,

I am posting for the the nurses of the Vascular Access Dept. of my hospital. They specifically asked me to ask you all here. :) I am the librarian and am doing research for them. Since you are the experts, I hope you can help with some information they are looking for. I have already ready checked the older postings on this topic, so I am hoping for some new, fresh and current information that I can give them that is happening around the country. I have done the "library research." LOL But they also want to know what other people are doing and that is where you all come in.

The Question:

The Vascular Access Dept. Nurses here would like to know if you are still using Biopatch with Port-a-Cath's. If so, would you be able to share policies, procedures or any other information. If not Biopatch, what are you using and why? Any information would be greatfully accepted.

Thank-you in advance,

Deweydecimal13501

[email protected]

[JustBeachyNurse, LPN]

Have you contacted the infusion nurses society?

https://www.ins1.org/m/index.cfm

National guidelines are here:

https://www.guideline.gov/browse/by-organization.aspx?orgid=1238.

[deweydecimal13501]

Yes and the Oncology Nursing Society. Both very helpful. Have the guidelines, etc. But they wanted to know what other hospitals were doing. So here I am....

[emtb2rn, BSN, RN, EMT-B]

Yes. Always. The patch is included in the start kit. Blue sky up.

[IVRUS, BSN, RN]

A "Port-a-Cath" is ONE type of Implanted Port.. And what my organization does is this: We will place a Biopatch around the insertion of ANY Central Catheter if the patient is Neutropenic, or has orders for it, otherwise it isn't used and we do excellent site care/cap protection and cleansing in attempts to keep infections at bay.

[dream'n, BSN, RN]

We always use a biopatch with ports, and all other central lines. Our unit hasn't had a CLABSI in years

[Asystole RN]

With my work I have traveled to hundreds of hospitals within the Western United States, usually a new hospital every week.

This topic comes up frequently with my line of work. The thing with using CHG-impregnated dressings and foam disks like the Biopatch is they are only good at reducing extraluminal infections which is the primary route for CLABSI for CVADs under 14 days of age. The use of CHG with CVADs older than 14 days has not shown to make a difference. This is straight out of the 2016 INS Standards.

The CDC with their BSI Prevention Guidelines only recommend using CHG-impregnated dressings or foam disks if the facility cannot otherwise control their CLABSI rate with strict adherence to basic prevention measures including education and training.

I will say though a lot of hospitals will have their inpatients use CHG but not their outpatient. More and more hospitals are seeming to move away from using CHG with ports. At $4-$6 a Biopatch I can see why considering the money can be better spent on more proven interventions.

The only reason why hospitals do use them with ports is because of Ethicon's efforts to push for every line, every time despite evidence, standards, or guidelines...for obvious reasons.

[IVRUS, BSN, RN]

The only reason why hospitals do use them with ports is because of Ethicon's efforts to push for every line, every time despite evidence, standards, or guidelines...for obvious reasons.

I believe that many hospitals also use them routinely because if they have a patient in a Med A bed who develops a CRBSI, doesn't Medicare stop paying the hospital monies for that patient?

[deweydecimal13501]

Thank -you for all your help on this question. The Vascular Nurses at my hospital are very appreciative as well.

[Asystole RN]

I believe that many hospitals also use them routinely because if they have a patient in a Med A bed who develops a CRBSI, doesn't Medicare stop paying the hospital monies for that patient?

Hospitals use them on ports because they were told by the salesman that they patient's would develop a CLABSI without it when the studies, standards, and guidelines do not support the routine use.

With the exception of fresh healing ports (even that I doubt they are at the same risk of infection like a fresh PICC or CVC), they are at the risk of intraluminal infections, not extraluminal.

[Courtney Nurse Writer, BSN]

I work at an outpatient clinic infusion room and we do not use bio patches on our ports. Perhaps it's because they are literally in and out?? Though when I worked at a hospital I do not remember using them there either. I really only see them on PICC lines. I'm trying to visualize anyhow how it would work on a port and can't seem to picture it.

[dianas02]

I work in outpatient pedi heme/onc infusion center and we use biopatch on all Port-a-caths, PICCS, and CVCs. It is our policy to always use the biopatch unless they have had previous skin irritation from it.