We have a new CVL maintanence policy on my unit. It seems that our educator has deemed that it is not "best practice" to suture our central lines in place anymore due to the risk for infection.(Not that we had an increase in central line infections- but I digress) Anyway.... so our docs are no longer suturing and we are using Stat Locks and changing them weekly with the dressing change. Well, of course, all of us hate this idea including the docs. Just makes us nervous. In fact 2 babies with IJs have had their lines slip out- thank goodness we are all SOOO nervous about the whole thing that we are checking those sites every hour diligently- these lines did not infiltrate, but what if??? Since the near miss incidents- docs have been suturing IJs on the babies but using stat locks on everything else.
My question is...... is anyone else doing this??? Please tell me not to worry and it will all be ok!!???:spin:
Feb 13, '09
Nope, we're suturing. We only use Statlocks on PICCs and sometimes not even then. And our policy for those is that only the NP or the transport nurse can change them. (Not sure why that should be, but there you go.)
Feb 14, '09
We suture all CVL's at this point. We are participating in a large study of CVL infections, and have had no CVL infections here in almost a year now. Needless to say, our procedures are very meticulous. The Statlocks were trialed here with staff for PIV's, but I don't remember discussion for CVL's at all. To be honest, even for PIV's, they were not generally accepted and seen as an unnecessary expense, as we have not had issues with PIV infections at all. And really no more secure than a good, sterile tape job on a PIV.
I'd say we will stay this course for the time being. I will ask our MD in charge of the study for his opinions regarding suturing vs Statlocks for CVL's...
Feb 14, '09
I think this all stems from the new JACO "never events".... central line infections is now one of the things that Medicare/Medicaid will no longer pay for and the private insurance is right behind. Like I said- not like we have any problem with line infections. I guess someone needs to be published or something!??! I really wonder what the infection risk is for sutures is anyway- I mean- we have been suturing line in for how long now??
Feb 25, '09
For us CVL's are sutured, statlocks for PICCs. I wish PICCS were sutured too. I hate trying to change the statlock, especially on neonatal PICCS.
Mar 4, '09
Are the sutures nylon or silk...long ago i used to suture the piccs...then we switched to steri-strips (to decrease infection) and now use the stat-loc and steri-strips. when you use the statloc and steri-strips you have to use a lot of skin prep...and make sure you change the stat loc at least every week at the minimum or you defeat the whole purpose. if you must use sutures...I would say just use the nylon as it is a lower risk for infection...perhaps if you can counter with the research you can change back. The stat-loc/ster-strip combo really works if dressing are changed on time and /or when compromised.
Mar 9, '09
We still suture our CVL's, have changed our catheter related BSI practices a little bit (creating a med-line with a port for blood draws, so as not to access the line as frequent, as well as cleansing techniques) and have found that our rate of BSI has gone down.