picc line dressing change

[sweetieann]

Just a quick question-- Are routine dressing changes (q 7 days) usually ordered at your facility for your patients, or is this strictly "nursing measure"?

[Reno1978, BSN, RN]

I find it interesting that many have commented that injection caps are changed Q7 days. We change them Q4 days / 96 hours along with our IV tubing. We do not change them with every blood draw.

Another thing we do to ensure patency is to flush each lumen with 2mL of Heparin (100:1) Q12H and after each use.

[NurseyPoo7]

What are the steps to do a PICC drsg change?

[Christen, ANP]

We only use heparin in dialysis catheters - only saline here!

PICC line dsg change is done using sterile technique, just like any other central line dsg change. I don't know how your central line dsg change kit is, but this is how we do it:

1) Wash your hands, put on clean gloves, mask, and hair cover and place mask over pt's face.

2) Remove old dsg

3) Using sterile technique, don sterile gloves, clean site with 3 swabs of alcohol, clean site with chloraprep, apply skin protectant to area which tegaderm will cover, apply statlock (we use these instead of sutures for our PICCs, but still use sutures for TLCs), apply biopatch, cover with tegaderm, date/time/inital

4) wash hands and get outta there!

[NurseyPoo7]

We only use heparin in dialysis catheters - only saline here!

PICC line dsg change is done using sterile technique, just like any other central line dsg change. I don't know how your central line dsg change kit is, but this is how we do it:

1) Wash your hands, put on clean gloves, mask, and hair cover and place mask over pt's face.

2) Remove old dsg

3) Using sterile technique, don sterile gloves, clean site with 3 swabs of alcohol, clean site with chloraprep, apply skin protectant to area which tegaderm will cover, apply statlock (we use these instead of sutures for our PICCs, but still use sutures for TLCs), apply biopatch, cover with tegaderm, date/time/inital

4) wash hands and get outta there!

*clueless what you mean by skin protectant, statlock and biopatch*

[Christen, ANP]

LOL - sorry

In the kits we use, a skin protectant is like a barrier we place on the sterilized skin in order to keep the skin from breaking down from repeated ripping of sticky stuff (ie, tape) from the same site. it also helps the tape stick better. It's the same size and shape as an alcohol pad.

A Statlock (I think that's a brand name) is the name of the securement we use in order to keep the PICC from falling out. In the picture below, it's the white thing on the left that looks kinda like wings holding the purple power PICC in place. They're tricky to place, btw.

A Biopatch is a little circular thing that contains antimicrobials on it that is used to try to keep the line from being infected. It's the circular thing that is directly over the insertion site in the picture below. :) It is placed "shiney side down."

[NurseyPoo7]

thanks for explaining. Ive never had to do a PICC drsg change, but Ive had pts go down for PICCs and hep locking them and such.

Whats the diff. between a regular PICC and a PowerPICC like you posted?

I think I'm clueless about the dressing changes and those other supplies you mentions (biopatch, etc) b/c Ive never seen any of them in our supply rooms.

[Christen, ANP]

We switched to the Power PICCs basically cause you can run IV contrast in them. Before we got these, if a pt with a PICC went to CT scan, we'd have to start a peripheral IV on them! LOL - I mean, they have a central line for a reason, ya know?

In my hospital, all of the nurses who do patient care are responsible for changing these dressings. We have a PICC Team, a group of RNs who place the lines, but we're responsible for maintaining them.

We have a special central-line kit that contains all of the stuff needed to change the line except for the statlock, which we drop onto the sterile field. :)

[jnrsmommy]

LOL - sorry

In the kits we use, a skin protectant is like a barrier we place on the sterilized skin in order to keep the skin from breaking down from repeated ripping of sticky stuff (ie, tape) from the same site. it also helps the tape stick better. It's the same size and shape as an alcohol pad.

A Statlock (I think that's a brand name) is the name of the securement we use in order to keep the PICC from falling out. In the picture below, it's the white thing on the left that looks kinda like wings holding the purple power PICC in place. They're tricky to place, btw.

A Biopatch is a little circular thing that contains antimicrobials on it that is used to try to keep the line from being infected. It's the circular thing that is directly over the insertion site in the picture below. :) It is placed "shiney side down."

I'm not sure if it's just the picture, but the biopatch looks like the white side is up. I can't remember what side is shiny, but I was taught to put the blue facing up (blue to the sky). Wonder if this is something new, or something we were taught wrong

Ooooh, and the statlocks. Man, I love the person that invented those things. They work well w/ peripheral IVs as well. Did I mention I love those things? LOL

[Christen, ANP]

OMG, love the statlocks for PIVs. Love/hate relationship with foleys (our pts tend to squirm / move around a lot, so they, like, never stick. or when they stick to our long termers they've caused blisters! )

And oops, it's shiney side up! Sorry, wasn't paying attention when I typed that obviously! Thank you for the correction.

[swilcher]

It says on the Biopatch packaging to place with the blue side facing up. This is the "shiny" side so I am not sure what the other person meant.