Lines not being sutured?

[JustKeepSmiling, ADN, BSN, RN]

Do you encounter a lot of lines not being sutured? Central, dialysis, alines?

I did a dressing change yesterday on a trialysis that had not one suture and no securement device. No apparent reason either. I was pretty mad!

Curious what others encounter and do you have policies?

I work at a large teaching hospital. So naturally tons of residents, variable skills and techniques. I help guide them and offer advice, they are always appreciative of the help.

I just cannot believe this trialysis was left unsecured. Even if suturing was not an option because of a bleed risk, etc - could have at least used a sterile IV catheter securement device.

[nrsang97, BSN, RN]

It has happened occasionally. Usually our lines were sutured in.

[JustKeepSmiling, ADN, BSN, RN]

I get it if it was dropped in emergently but still there are ways to secure it without taking time to tie a neat bow.

I don't think we have a policy on this, going to bring it up to the powers that be. For a sick ICU patient to lose a good line just because it wasn't properly secured is not cool and then the risks of infection, hemostasis, needing a new line...

[nrsang97, BSN, RN]

Sometimes I was able to save the line and if so I had someone call the resident to come and suture it.

[dexm]

I also work at a large teaching hospital and come across this occasionally. We have a doc on call on our unit, so I just page them to come suture it.

[JustKeepSmiling, ADN, BSN, RN]

They will come suture it in when we ask. I just don't like that sometimes they think the sutures are optional and want to promote a policy for it.

[Twinmom06, ASN, APN]

Permanent dialysis catheters don't necessarily have sutures in them (or if they are long standing the sutures have long been removed). They are tunneled and have a capsule under the skin that holds them in place and discourages infection.

[FloridaGatorRN]

In my hospital we do not suture lines anymore. We exclusively use stat-locks.

FloridaGatorRN

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[AnnieOaklyRN, BSN, RN, EMT-P]

Sutures increase risk of site infection, which is why many physicians and facilities are moving away from suturing. You can ask your nurse manager about ordering Statlocks, they work great!

Annie

[iluvivt, BSN, RN]

You Really need to look into using the Secure-A-Cath.Is is placed at the time of insertion with two very small pieces of nitinol anchors that secure it to the skin...great product...easy to clean the site with 360 degree cleaning capability...easy to place...education is needed to learn to remove them though. It is easy once you do it and as long as people don't yank on them to dc them.

[JustKeepSmiling, ADN, BSN, RN]

Going to look into that!

We have statlocks for PICCs, but they aren't compatible with other lines.

It wasn't a permacath. It was an IJ trialysis.

Now if we could find something to keep the cordis/swan from flopping around and aggravating patients we would be on a roll!

[iluvivt, BSN, RN]

There is a competitor to stat loc that allows you adjust the section that you place the sutures holes in to lock it in place. They slide so you can make them fit but I am still a fan of the SecurAcath

I have placed and removed them. They seem strange at first but they really do not hurt to place them and the site has been injected with lidocaine. You must learn how to DC them and there are two ways and it is easy once you learn.