[font=book antiqua]hello, i would like to ask for some help, tips, ideas...whatever you've got. i am an inpatient oncology/med/surg. nurse and have been on my unit for almost 3 years. we recently changed to new dressings on our central lines after they were trialed at another area hospital. they are called sorbaview. every time i have changed one it sticks to both the antimicrobial disc and the picc line to the point where i am concerned about dislodging the line as i try to get the old dressing off. i hate them!
i have started bringing in sterile suture removal kits to hold the line while i remove the sticky stuff (also our discs seem to never come off like they should), but i am concerned about pinching the line and trying to maintain sterility. i even bring in multiple pairs of sterile gloves. i dread these dressing changes because they can take up to 30 minutes depending on the state i find things in.
do you all have any solutions or tips to offer? we are not a magnet facility so there is no "practice board" that i can go to. i even thought about taking a poll of the whole hospital, but don't want to make waves i can't survive. what kinds of options are out there?
Jun 19, '12
Sorbaview Shield Application and Removal - YouTube
I just watched this video about application and removal. The removal seemed pretty straightforward. Are you pulling parallel to the skin in the opposite direction of the catheter? How often is the dressing changed? Are you using any kind of additional adhesive under the dressing? We don't use Bio-Patches under our dressings- are they sticky as well? Do you have an adhesive remover that you could use to help with removal?
Is there a way you can remove as much of the dressing as possible with your clean gloves, then put on sterile gloves to stabilize the catheter while you remove the portion of the dressing attached to the catheter?
Jun 19, '12
Yes, attempting to pull in opposite direction. Bio patches should not be sticky, but they often are not placed with the slit opening in such a way as to make removal easy when the window portion of the dressing is adhered to it and the PICC line (they often come up together making potential movement of the line a real risk right at the insertion point where the disc sits!) I will look for the video though-thanks.
Jun 19, '12
The patch should not come up because you should not be lifting the dressing up when you remove it. You should fold it back on itself and pull it in the opposite direction of the catheter while stabilizing the line with your other hand. Try to keep the dressing as close to the skin as possible when you peel it back.
Also, with many transparent dressings, if you first pull the dressing straight out to the side it will release the adhesive and then you can pull it off much more easily.
Jul 18, '12
[font=book antiqua]i would simply have your education dept contact the centurion rep (sorbaview manufacturer) and j&j rep (biopatch manufacturer) for an in-service.
like the other commentary, sounds like a problem that can be corrected.
Sep 28, '12
I use a lot of alchohol preps and soak the alchohol on sides of dressing and it lifts easier. Then when you get to where the statlock is stuck on dressing,use alchohol to seperate it. There are also adhesive remover preps which make it easier!