We are looking for some experienced opinions.
1. We are working on a PICC line Dressing poster. When were first taught the use of the Centurion Sorba view PICC dressing, we were taught that the wing potion of the PICC line needed to be placed within the blue line.Now our rep is saying they need to be in the window protion of the dressing or above the blue lines. What are you all seeing.
2. We have very little experience with guaze dressings over PICCs due to adhesive intolerance. We know that PICC dressings are semipermeable, does this mean you only tape the outside edges of the guaze with paper tape? Or do you cover the entire dressing with paper tape?
All ideas and replies welcome
Thank you
Carolyn Bonanno RN
I have used the SorbaView Shield for the past several years and the "wings" on the PICC must be "above" the blue securement lines And you must be able to observe the insertion site so most of the time our dressings have the wings farther above the little window in the middle of the blue lines. Hope this helps.
Valorie
Valorie Dunn,BSN, RN, CRNI, PLNC
The entire gauze surface must be covered with tape. "Semipermeable" only applies to a TSM dressing. Uncovered gauze could easily allow excessive moisture to reach insertion site. 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
Thank you yes it does clear some things up and will help with discussion we have been having.
Carolyn Bonanno RN
With Sorbaview Shield, the hub of the catheter must be proximal to the blue integrated securement piece. If you have questions, look at the videos at sorbaviewshield.com Your rep should be able to provide all the educational materials you will need to educate on the device your facility uses.
In our facility we use Mepilex or Mepilex Ag instead of gauze. It is a silicone-based glue that does not cause reaction and is easily removed. We then place fishnet stocking over it. The Ag is siler-impregnated & does wonders for contact dermatitis from regular dressings.
ReneMaslow, MSN, VA-BC PICC/Proc RN Kaiser Permanente Santa Rosa, CA
Sounds good but there is one issue. there is no evidence to support a silver impregnated dressing like there is to support CHG dressings. No studies on silver dressings and they have been around for a long time. I am not sure why no one has studied this for reduction of CRBSI or CLABSI. 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
there are no studies on silvasorb??? To be honest I haven't searched. The little discs for piccs are a booger to handle with gloves but I have used them in the past.
Correct - no studies in silver for prevention of CLABSI or CRBSI. CHG is the only agent referenced in the 2016 INS Standards and other documents such as the 2014 SHEA Compendium. 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
We currently work with several home infusion pharmacies, and at least one whose first choice is a silver disc and not a CHG disc. I am teaching from and referencing the 2016 INS Standards of Practice, so this is definitely not in alignment with the Standards. We have little control of the supplies we receive. If we are able to specifically request that all of our patients receive the CHG disc because of the lack of information to support the use of silver products, is there any additional information, beyond INS and SHEA, that I can reference that supports this? I have already been told by one of the pharmacies that they had numerous patients with adverse reactions to CHG and have done their own study with a silver dressing and that is why they have chosen this as their dressing of choice.
BJ Emory, RN, CRNI
Director of Infusion
Personal Touch Home Care
The only thing I can recall on silver are white papers from the manufacturers which is a marketing piece and not regarded as evidence. Have you done a literature search? 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