Input on IJ dressings

[amy1197]

Hi Everyone, I am an RN on the IV team and have to do a preformance improvement project for school. My project is going to be a study to see if a tubing securement device with help maintain the integrity of the central line dressing. In our facility we are using a chlorhexadine impregnated tegaderm for our central line dressings. We find that our IJ dressings are only staying intact for a few days at a time and are rarely lasting the 7 days we would like them to. I believe that the problem is a combination of poor skin prep prior to the dressing being applied and/or the weight of the tubing/lines that is putting a strain on the line and causing the dressing to become unocclusive. I am just trying to find out a little bit about what other facilitys are doing or if they experience the same problems. do you use some type of securement device or what type of dressings are you using? Here is a link to the securement device we will be trialing. It is the tubing securement. We still suture our lines in. Thanks.

Amy

[MunoRN, RN]

I agree that the tubing has to be secured outside of the dressing for the dressing to stay intact, but I'm not finding your link to the device you are considering, can you repost the link?

[amy1197]

Hi Everyone, I am an RN on the IV team and have to do a preformance improvement project for school. My project is going to be a study to see if a tubing securement device with help maintain the integrity of the central line dressing. In our facility we are using a chlorhexadine impregnated tegaderm for our central line dressings. We find that our IJ dressings are only staying intact for a few days at a time and are rarely lasting the 7 days we would like them to. I believe that the problem is a combination of poor skin prep prior to the dressing being applied and/or the weight of the tubing/lines that is putting a strain on the line and causing the dressing to become unocclusive. I am just trying to find out a little bit about what other facilitys are doing or if they experience the same problems. do you use some type of securement device or what type of dressings are you using? Here is a link to the securement device we will be trialing. It is the tubing securement. We still suture our lines in. Thanks.

Amy

http://www.centurionmp.com/products-services/products/cvc-catheter-securement-anchor-system/

[iluvivt, BSN, RN]

I have a few questions? How long are you leaving your IJs in place? Is someone with a lot of IV experience checking them the day or the day after they are placed? Who is doing all the IJ dressing and cap changes in your facility. Sounds like you are using tagaderm with the CHG already impregnated on the TSM...are you willing to try another product? Is that strictly an IV team function or does everyone perform the task. If everyone performs the task it will need a broader approach to teach and train the RNs. I have some ideas for you but it would be helpful if I can get the questions answered?

[MunoRN, RN]

Tension on the tubing outside of the dressing can easily ruin an IJ dressing, we used to anchor the tubing to the shoulder/clavicle area with tape, although lately we've been using StatLock anchors for foleys, which work particularly well for Cordis introducers. We use a medline CL dressing kit, and you don't use the little extra dressing piece for under the tubing where it exits the dressing then it won't last as long and won't be all that occlusive.

[Fumanchuesday]

StatLock actually makes anchors for central lines that are smaller but similar to the foley StatLock anchors

[MunoRN, RN]

We use both, Stat lock central line anchors that attach to the suture points on the central line, then also another anchor outside of the dressing to hold the tubing, so that if you pull on the tubing it won't pull on the dressing.