Taping IV Catheters

[Zee_RN]

We currently have a debate at our institution concerning the taping of peripheral IV catheters. Our institution uses IV catheters with 'wings' and we commonly place tape under and over the wings to secure the catheter (forming a kind of 'U' shape--not a chevron and the tape does not touch the insertion site). We then place a transparent dressing over the site. Our Infectious Control nurse says we are increasing the risk of infection by placing tape under the transparent dressing; that we should use only the transparent dressing to secure the catheter. We are worried that we will simply be subjecting the patient to daily restarts as we replace the IVs that have 'fallen' out. Ideas? Comments? Thanks!

[KIWIRN]

in the past we used steri-strips to anchor the tape under tegederm, but now we have a special I.V. dressing that comes with 2 pieces of tape and a combination fixamul-tegederm dressing (all sterile packaged and easy to access) the clear part sits over the entry site so it is visable at all times.

[PButler]

Tegaderm by itself should work just fine as long as the rest of the IV tubing is well secured with tape. In our ICU we use veniguard (the foam donut with clear tegaderm center). They provide excellent infection control and stick better than anything else I've ever used. Our IV's usually don't come out until they need to.

As for the comment about anethesia and paramedic IV's....We D/C and replace any line that comes from outside the ICU...even the OR. (Believe it or not, anesthesia can have terrible sterile technique when it comes to line placement) and having worked in the prehospital setting I know that getting the IV is priorty and sterile technique is a joke.

[RNforLongTime]

I believe that the Infusion Nurses Society reccommends that only Sterile tape be placed under the transparent dressing of a peripheral IV. The IV start kits that our facility uses has a little roll of 3-M transpore tape. So, if you use a start kit that has sterile tape in it then all is Ok. I too am of the belief that the Tegaderm alone will not anchor the IV site enough so that I will not fall out.

I tape mine using the U method that Zee mentioned in her post even though our facility uses the Protectiv IV catheter(no wings). I saw the nurses on the IV teams at the hospital I used to work at do this and that facility uses the same kind of IV catheter that I use at my current facility. Those IV's rarely fell out.

[cmggriff]

I am no infection control guru, but all the research I have read says the key to preventing infection at the iv site is changing the site at least every 72 hours. That includes all those prehospital IV'S as well as the sterile prep and drape subclavians put in by surgeons. Gary

[psnurse]

The IV Nurses Society is probably where this originated. At least that is where they point when we ask about this policy. And how to tape your IV is a policy where I work.

No tape under the transparent dressing. Can chevron outside the transparent dressing. Have no problems with them falling out.

[nurs4kids]

I have a real problem with this 72 hour changing policy. We, like KRVRN stated, leave PIV's in until they go bad (sometimes as long as two weeks). I have NEVER, in six years, seen an IV infection here. Our Infection Control Department did a study on this and found no proof of increased risk of infection > 72hrs (this study was several years ago).

As for securing: With kids, the biggest risk IS their pulling it out. We use tape to secure many of our IV's. Tegaderm ALONE, without tape over the site, works better than tape alone. Then secure the tubing with tape. I rarely loose one.