Does anyone have any experience using parafilm to protect CVL connections? If so, do you use it on specific patient populations and how often do you change the parafilm?
What is parafilm? If it is an adhesive type of dressing or tape, it would not be recommended for any junction on any IV administration set or catheter. Adhesive residue is left to attract organisms and dirt from the environment. Also there is no evidence to support use of any adhesive based product on these junctions. The standard of practice is for all junctions to be luer-locked. Lynn
Parafilm is not an adhesive. It is used in lab settings. It is flexible, moldable and moisture resistant. All our connections are luer locked. We are looking into to using it for pediatric patients with high risk factors, such as a leaky ostomies, to help prevent the connections from becoming contaminated. It is listed in a resource for patients with Short Gut syndrome to help protect the connections.
I did find some information about this product by doing a Google search. This might be a good idea but I have lots of questions about how it would work. I can understand the concern about body fluids finding their way inside the luer locked connections. There is no evidence for or against using this on connections for the IV administration set. I have never heard any discussion about this at any conferences, etc. So your facility would need to collect internal data about outcomes. My questions are 1) would this truly keep fluids away from the connection? 2) how does it change over time when placed around the connection? 3) what are the clinical implications of those changes due to temperature, humidity, tension, etc?) 4) how easy is it to remove when it is time to change the admin set? and 5) Is this an off-label use of the product and what does the manufacturer say about this use for it? Lots to think about. Lynn
Is Parafilm the stretchy film used on specimen containers for transport to lab? I've never considered it but it might be useful. What escapes me is the need to wrap connections, maybe better connectors would help? Are they coming apart? patients fiddling with them? what's happening to your lines?
We use Glad Press N' Seal to cover the dressing and tubing during baths and then remove once the bath is done in pediatrics. Works well and a lot of pediatric hospitals use this method. We have Aquaguard too but Glad Press N' Seal works better.
Mary Lynn Rae, RN, MSN, CPHON
Clinical Nurse Educator
Ann & Robert H. Lurie Children's Hospital of Chicago
This product is primarily used by the lab. However, it has another use in the addicted to narcotics population. When an addict has a significant infection and needs IV antibiotics thru a PICC, the hub can be covered with parafilm. It is quite obvious if it has been punctured or removed because you can't put it back on without it being detected. I have told patients why I am applying this product and that they will not be able to keep their PICC if they misuse it by injecting their favorite drug. This may seem quite parental but an additional PICC infection is not a small matter. Physician support for this approach is essential because occasionally you may have to back up your warning with action to remove the PICC and make a new plan of treatment. We change the parafilm after each use of the PICC.
I have read these posts regarding Parafilm and was so excited. However, I went to the lab and got a sheet of it. It does fold and wrap around the hub easily, but it also comes off easily and can be re applied. It just crumples and re sticks, how would you ever know if that was changed? Is there a different type or version of this product??
We also have tried applying the tegaderm dressing to the top of the hub caps etc. but....they are so messy and sticky and can be removed and re applied as above.
Hi Gina Our parafilm we used in our ED come on a roll was very easy to use. Could rip off the amt you you needed and made it easier to wrap around an end. Cindy
We used Parafilm at my last position at a children's hospital. This was presented at APIC last year. It is used as a barrier against stool, slobber, and anything else that can gain access to lines. It is removed before each access. It is also an approach that the adult hospitals were emplimenting as part of a CLABSI prevention bundle. IV drug abusers need treatment, however, they also need to be safe. Discussing why you are applying it opens the conversation of patient safety. This is much cheaper than an infection as well as improving patient safety.
Wouldn't an alcohol filled cap such as Curos or Swabcap provide the protection against stool, slobber, etc.? I can understand how it differs if you feel you need to wrap a connection to detect tampering. I guess I need to google it also......
What is parafilm? If it is an adhesive type of dressing or tape, it would not be recommended for any junction on any IV administration set or catheter. Adhesive residue is left to attract organisms and dirt from the environment. Also there is no evidence to support use of any adhesive based product on these junctions. The standard of practice is for all junctions to be luer-locked. 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
Parafilm is not an adhesive. It is used in lab settings. It is flexible, moldable and moisture resistant. All our connections are luer locked. We are looking into to using it for pediatric patients with high risk factors, such as a leaky ostomies, to help prevent the connections from becoming contaminated. It is listed in a resource for patients with Short Gut syndrome to help protect the connections.
Thanks!
I did find some information about this product by doing a Google search. This might be a good idea but I have lots of questions about how it would work. I can understand the concern about body fluids finding their way inside the luer locked connections. There is no evidence for or against using this on connections for the IV administration set. I have never heard any discussion about this at any conferences, etc. So your facility would need to collect internal data about outcomes. My questions are 1) would this truly keep fluids away from the connection? 2) how does it change over time when placed around the connection? 3) what are the clinical implications of those changes due to temperature, humidity, tension, etc?) 4) how easy is it to remove when it is time to change the admin set? and 5) Is this an off-label use of the product and what does the manufacturer say about this use for it? Lots to think about. 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
Is Parafilm the stretchy film used on specimen containers for transport to lab? I've never considered it but it might be useful. What escapes me is the need to wrap connections, maybe better connectors would help? Are they coming apart? patients fiddling with them? what's happening to your lines?
Something to consider especially for the pediatric population. We always have little hand that aide in disconnecting their lines. Cindy
Cindy Brown RN BSN CPN
IV Nurse Educator/Clinician
We use Glad Press N' Seal to cover the dressing and tubing during baths and then remove once the bath is done in pediatrics. Works well and a lot of pediatric hospitals use this method. We have Aquaguard too but Glad Press N' Seal works better.
Mary Lynn Rae, RN, MSN, CPHON
Clinical Nurse Educator
Ann & Robert H. Lurie Children's Hospital of Chicago
This product is primarily used by the lab. However, it has another use in the addicted to narcotics population. When an addict has a significant infection and needs IV antibiotics thru a PICC, the hub can be covered with parafilm. It is quite obvious if it has been punctured or removed because you can't put it back on without it being detected. I have told patients why I am applying this product and that they will not be able to keep their PICC if they misuse it by injecting their favorite drug. This may seem quite parental but an additional PICC infection is not a small matter. Physician support for this approach is essential because occasionally you may have to back up your warning with action to remove the PICC and make a new plan of treatment. We change the parafilm after each use of the PICC.
Interesting!
Keith W. Gilchrist, MSN, RN, PHN, OCN, CRNI, VA-BC
Oncology Nurse Navigator, David Grant Medical Center
Travis AFB, CA
We have a big issue with ivdu at our hospital .
I have read these posts regarding Parafilm and was so excited. However, I went to the lab and got a sheet of it. It does fold and wrap around the hub easily, but it also comes off easily and can be re applied. It just crumples and re sticks, how would you ever know if that was changed? Is there a different type or version of this product??
We also have tried applying the tegaderm dressing to the top of the hub caps etc. but....they are so messy and sticky and can be removed and re applied as above.
I am anxious to hear the feedback.
thanks, Gina
Gina Ward R.N., VA-BC
Hi Gina Our parafilm we used in our ED come on a roll was very easy to use. Could rip off the amt you you needed and made it easier to wrap around an end. Cindy
Cindy Brown RN BSN CPN
IV Nurse Educator/Clinician
Our bone marrow transplant hospital uses Parafilm on the catheter tip ends. It is changed when taken off for use or two times a week.
Mary Gough
The adaptive creative nature of nurses never ceases to amaze me. I love the Parafilm wrap on the infusion cap for the recreational drug user.
We used Parafilm at my last position at a children's hospital. This was presented at APIC last year. It is used as a barrier against stool, slobber, and anything else that can gain access to lines. It is removed before each access. It is also an approach that the adult hospitals were emplimenting as part of a CLABSI prevention bundle. IV drug abusers need treatment, however, they also need to be safe. Discussing why you are applying it opens the conversation of patient safety. This is much cheaper than an infection as well as improving patient safety.
Janine Pritchett, RN, BSN,
Nurse Manager
Option Care Home Infusion - Seattle Branch
Wouldn't an alcohol filled cap such as Curos or Swabcap provide the protection against stool, slobber, etc.? I can understand how it differs if you feel you need to wrap a connection to detect tampering. I guess I need to google it also......