Sutureless devices for PICC securement

[vascularaccessPA]

I'm a vascular access PA placing PICCs. I still suture them despite the recommendations to use the sutureless devices (Statlock). My reason is that most of my patients are discharged from the hospital several days after PICC placement and I have been unable to get assurances that the home nursing or rehab facilities have the supplies and ability to change the device every 7 days as recommended.

For those of you in a similar situation do you use the Statlock and hope it gets changed? Have you had instances where patients come back for PICC replacement because the Statlock was not changed?

Looking forward to hearing your experiences...

[jess41378]

I am a home infusion nurse and find that the pharmacies don't always send statlocks at first. We have to request them sometimes. I always have an extra supplie of statlocks for that reason. I do change them every week because they might hold bacteria under them if their not changed weekly. They also tend to rip apart with the tegaderm when taking old dressings off. I do like the sutures better because sometimes the statlocks are difficult to use.

[Rexie68]

I'm an RN on the IV team at a hospital. We very rarely suture in our PICCs. Our home health care agencies have had no trouble getting Statlocks and we've had no trouble with that. The statlocks that we use don't tear other than the original one in the PICC kit....that ones seems to be made of a foam-like material while the stock Statlocks are made of a cloth-like material and don't rip.

[iluvivt, BSN, RN]

It sounds like were are aware that the recommendation from INS is to use an engineered securement device, such as the stat loc. INS came to this conclusion b/c of 2 main reasons. First, Biofilm grows on sutures..and where are they...... right at the site putting the pt at increased risk for infection. Second, OSHA's position paper calls for an elimination of sutures on all medical devices due to the risk of needlestick injury. The manufacturers are rising up to meet the need. Now your second issue... I can see that you realize that putting in the PICC is really only the first step and that good nursing care is necessary....I always say that NO PRODUCT can substitute for GOOD nursing care. You need to evaluate those agencies that you are referring your home care PICC pts to and make sure they have nurses familiar with PICC care. Also you need to train your pts and/or their caregivers....I hAVE A TEACHING SHEET thay explains that the caps...steri-strips...TSM..stat loc or other securement devices need to be changed at least once per week and if not clean dry and intact. I also tell them the importance of the amt left visible..should stay that way and the person removing the dressing needs to very careful not to pull the any of the PICC out. This step alone works wonders..pts are very protective of their PICCS and they do listen..also teaching them how to cover it for bathing and showering is critical for the home care pt. I also tell them to please share the sheet with the nurse that will be taking care of them. Yes I have called home care agencies to tell them what the standards of care are..they do not always like it but I really am doing them a favor and saving them from a potential lawsuit. One thing that is problematic with sutures is that often the PICC will get pulled a little bit..tug on the suture and occlude it and the nurse can't figure out what is going on..used to see this a lot with the silicone catheters but it does happen with the polys as well

[sorlando]

If my facility does not have any statlocks at time of dressing change, is there something that could be used instead?