IV stabilization devices (StatLock) love or hate

flightnurse2b, LPN · Jun 22, 2008

i love statlocks!! they dont have them at the facility i work at now, but i am begging my boss to order them. they really can save your site, especially if theyre a hard stick. the pt also gets to have more freedom with the extremity the site is in....

Pediatric Critical Care Columnist · Jun 22, 2008

I would love 'em if we ever had a consistent supply of an appropriate selection. We get very few PICCs but have a drawer full of the StatLocks for them. We also had a supply of the Foley stabilizers, which I ADORE but when they ran out, that was it.

iluvivt, BSN, RN · Jun 22, 2008

One of the complications of peripheral cannulation or using peripheral veins for IV Therapy is they get irritated. One of the complications is phlebitis. One of the ways to minimize this is to stabilize the site properly. I often see nurses doing this improperly or not so well. The cannula should be tacked down well with a chevron method a modified chevron or the H method and covered with a TSM dressing. Then if continuous IV fluids are going to be administered the nurse should secure that line so the tension is on that tubing instead of the site. There are other causes of phlebitis other than mechanical but the stat loc secures the cannula so well it certainly will diminish this aspect of the cause. In the meantime, any nurse can secure a site properly. It often takes me longer to secure a site that it does to start the site since I know how important it is to increase the dwell time. There are a few studies published showing a dramatic decrease in phlebitis rates and thus restarts with the use of peripheral stat locs. Perhaps you can supply your employers with those articles.

Pediatric Critical Care Columnist · Jun 22, 2008

The problem isn't that they don't think they're a good idea; they're aware they'd decrease complications. The problem is that no one is accountable for anything any more. No one takes responsibility to make sure the "custom" items we are being exhorted to use are actually available for us when we need them. For example, our ANP revised our sternotomy dressing practice, but didn't tell the stores person and have our supplies list amended, so we never have the correct dressing components. In fact, if it's not a 2x2, a 4x4, a small Mepore or a small Tegaderm, chances are we won't have it in our unit. I did a dressing on a kid with a spinal instrumentation with the ortho ANP a few weeks back and we had to send the nursing assistant to another unit for Telfa! Oh, and the only lines we're permitted to use BioPatches on are femoral arterial lines. If we can find them in the first place. The nursing staff brings these issues up at every staff meeting and still we're wandering around looking for things all the time.

iluvivt, BSN, RN · Jun 23, 2008

Oh I see the problem now. You need to stress to them that if you are expected to follow the policies and procedures of the hospital and provide quality nursing care that is evidenced based that you must have the supplies readily available. Your supply level must be increased. I would page,leave a message or E-mail the manager every time ,and I mean every time, I needed something that should be there in adequate quantity. They will be sick of it, and be very nice every time you communicate. Continue to bring it up in staff meeting and state this was a problem brought up last mo that was never solved. In terms of the biopatch perhaps you can show them the studies done. The use of the biopatch decreases CRBSI (catheter-related bloodstream infections) by 50-60%. That is a huge decrease. In addition.Medicare will no longer pay for these infections starting in October of this year so I am shocked they would not want to pay 5 bucks as opposed to the 25 thousand or so to treat a bloodstream infection. This sounds like money concerns or bad managment. What do you think it is?

Pediatric Critical Care Columnist · Jun 23, 2008

I'll take "bad management" for $2000 Alex. I've worked on this unit five years and nine months. In that time we've had two patient care managers, two acting patient care managers and a total of twelve unit managers. Oh and three clinical nurse educators and two directors of nursing. Also in that time the turn-over of staff nurses has gone well over 100.

The whole hospital is following the "just-in-time" business purchasing model without taking into consideration that health care isn't like a business, it's not predictable and it's not one-size-fits-all. We're always running out of things we use all the time, like 500 mL bags of NS!! What kind of hospital runs out of NS???? One week we were out of blood filters. We're always short of linen, dead-enders, ABG bubble eliminators, antireflux valves, 8Fr non-weighted feeding tubes... the list is endless. We also run out of paper goods like our Z-fold flowsheets, and have to use poor-quality photocopies of a photocopy, stapled together. What we never run out of is bodies in the beds!

We've shown the studies, we've made the calls, we've talked it to death in both our staff meetings and our team building meetings, and still we have to hunt for things all the time. Our unit is being studied as part of a research project into the effects on nursing work flow by introducing computerized charting to ICUs and I'm one of the nurses who is being observed for pre- intra- and post- introduction. The observer records every interruption to care and the duration of same whether from other staff creating distractions, having to go get meds or supplies not avaialbe at the bedside and so on. That information could be very useful even before the study is complete... if they could distill the amount of time spent just looking for things that should be available and aren't.

Since I work in Canada, there's no issue with reimbursement for hospital-acquired infections at this point in time. So many things we do are penny-wise and pound-foolish, like paying over time for half the people on a shift because the schedule wasn't amended in time to ensure there was enough staff on. Because our scheduling is done about eight months in advance, there should be some way today to see that on July 19 there will only be 6 nurses on days and we need 18, so we should start moving people around or calling in casuals now. Yeah. No. It's frustrating in the extreme.