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ogm
PICC Dressing-Biopatch & Securement Device

A question came up here @ AGH- When changing PICC dressings should the securement device be placed first,  then the Biopatch or vica versa? Does the sequence matter and why? What, in everyones opinion is Best Practice ?

Thanks

OGM

Chris Cavanaugh
Not sure it would matter

I cannot think of any reason why it should matter, as long as it is all done with sterile technique with each dressing change.

Chris Cavanaugh, RN, BSN, CRNI, VA-BC

lynncrni
And the Biopatch must be in

And the Biopatch must be in contact with the skin surface 360 degrees. It can not be placed on top of the catheter. Lynn

Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI

Lynn Hadaway Associates, Inc.

PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

ILP
Potential issue

Lynn is correct. Biopatch must be in 360 degree contact with the patient skin otherwise it is useless to protect a patient. CHG has to be in contact with the skin to protect it and if you do not have all of the biopatch touch the skin, a pathway to infection is left open. As for technique, a sterile method must be used but I would not think it would matter if you put the securement device down first or the biopatch. Better yet, why not try a tegaderm chg which does it all in one for you and offers catheter securement.

 

I puckett

Tulane

dlpiccrn
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PICC Nurse

Interventional ...
Biopatch & securement device

Use CHG impregnated Tegaderm and get both in one simple application. Antimicrobial and securement and a cost savings as well.

Carole Rumsey
I have done multilple joint

I have done multilple joint visits with nurses and although everyone is right that it shouldn't matter as long as everything is sterile that isn't what happens at times.  I find that if the nurse puts on the statlock first they may touch the skin (that hasn't been cleansed with Chloraprep) or the lumens that are usually outside the dressing and not sterile.  The nurse will then not change out her contaminated sterile gloves and will then go to what I feel is the most vulnerable area (insertion site) and put the biopatch on...which is now not totally sterile due to the nurse not changing out her gloves.  Thus, I train the nurses that it might be best to put the biopatch on first and then the statlock. 

Carole Rumsey, RN, CRNI

Home Infusion Program Manager

Sutter Infusion and Pharmacy Services

Sutter Care at Home

Northern CA

[email protected]

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