Forum topic

 Using published studies as scientific evidence, this dressing would be part of a stabilization system when it is combined with a peripheral catheter that has wide wings or a stabilization platform. There is no published evidence of how this dressing performs when applied to a traditional round hub catheter. See the INS standard on catheter stabilization as this is part of that standard. Lynn

We have been using this dressing for 2 years and have not had a CLABSI in that time.  We have had the rare patient develop a sensitivity to chlorhexadine and had to change dressing type because of that.  We like it for it's stabilization but also use Statlock.  I have never been able to completely predict how much catheter is going to be left outside the patient and don't like to trim PICCs if I can keep from it so the Statlock is really important in my opinion.  The additional securement and convenience of this dressing is wonderful.  It takes a little time to learn how to detatch it for dressing changes but it is an excellent product in my opinion.

We switched to this dressing about 1 1/2 years ago.  We did away with the Statlock on most of or patients except we use the Statlock for our TPN and Inotropic patients or anyone that seems to be having problems with keeping their dressing intact.  It works well but we did have a learning curve and initially had a couple of PICC lines migrate out a few cm.  Tegaderm is great at sending out reps and clinicial nurse trainers to educate the nurses on this dressing. 

 I have no affiliation with Tegaderm.

We trialed the product but found that using it alone without another securement was risky for malposition when the dressing is removed.  Our experience has been that we get many skin tears and have reactions to the tegaderm on the many pediatric patients with fraile skin and decided to used the Sorbaview securement device instead.  We still use other securement as pediatric patients seem to have many incidents of getting the line pulled on in the course of the day.  Theresa

Theresa Reed

Texas Children's Hospital

Houston, TX

We saw that the Tegaderm securement dressing in homecare not only worked but saved the company money.  We expanded the use of this dressing to our hospital PICC programs.  One program uses the CHG securement dressing and another uses the plain securement dressing ( #1685).  On occasion, a decision is made to add a stat lock, if the patient is high risk for loosing the PICC, due to excessive moisture or confusion.   As mentioned, there was a learning curve for the staff nurses and 3M provided the clinical support they needed.  I do not have any affiliation with 3M/Tegaderm.

For what it is worth.  I have had good success using TSMs/Tegaderm (we use Tegaderm brand) as a securement device.  This was before all the other gadgets were available to us.  I start the IV and immediately place the first TSM over the catheter up to the connection.  I then place my fingers to hold pressure over the site and remove the last bit of catheter needle and attach my extension set.  I then curl the extension set in the best manner to keep the catheter in appropriate position in the vein, even propping the hub with a piece of sterile 2 x 2 from the kit if needed to prevent traction on the catheter.  I then cover the loop I have made with a 2nd tegaderm.  The remaining piece of extension is taped to the tegaderm instead of the skin to prevent tape irritation.  Our observations (no studies) have shown this to be a very successful way of inexpensively securing even the round hub catheters as you have secured the whole loop.  Arm bands etc do not catch on the loop and slide right up and over the tubing.  We seem to have much fewer accidental pull outs.  Of course this won't stop the determined confused pt from pulling out an IV but neither will anything else.  I now do this on every IV.  Approximately 25 cents is very inexpensive especially for your patients that are only going to have their IV for short term.  We have had no problems with many IVs staying intact for days.  The TSMs are easy on most skin.  I 

For confused pt's I want to ban coban (I don't know the generic name, looks kind of like ace wrap that sticks to itself).  I have seen too many disasters from the use of that product.  I cut out the toes of our gripper/slipper socks.  Use the largest size needed.  Put the cut end toward the arm pit and the cuff end becomes the cuff.  It can be rolled up or down to easily inspect the IV site.  Tubing can run up the "sleeve" and out the neck line of the gown to keep it out of the pt's way.  Put "sleeves" on both arms so that the pt doesn't know which arm the IV is in.  I instruct the nurses to watch for the pt to start picking at the area of the IV to indicate that there is pain and inspect again.  Our fall precaution pt's wear yellow socks so I use yellow socks on their arms.  That is VERY VISIBLE that they are on fall precautions.  It doesn't eliminate all pulling out either but we find it helps pt's keep from fiddling with tubings, doesn't get too tight like wraps can and is easy to move for inspection and recover. 

I know that there are many fine products for securement out there.  We are working hard at cost control and are finding that this technique is working well for us.  Our department is too small for me to try to do a study with controls.  For a long time I was the only one who did this.  We are a two person department.  Finally my coworker was sold on the idea and she does it all the time too.  That came from her follow up on how neat my IVs looked when she came back.  The proof for us was in the follow up.  When I get a chance to go back to school, I may make both items a project.  I would like to see if IV's last longer if we put "socks" over all IV's.  It seems to make sense to me that if we keep arms warm the veins will stay better dilated and may last longer.  We'll see.  Best to all.

Mary Penn RN  Vascular Access Team

Greater Saint Louis MO