We place a Biopatch over the site on the day of insertion if no bleeding and if they have fragile skin, where lifting the op-site may tear the skin, but in most cases the day after the insertion, when any bleeding from the insertion has stopped. We insert PICC lines on Adults.
We use bio patch here in Owensboro, we are using on all lines, including ports, just got policies finsihed. No problems so far with the product but still early to tell. We are putting on adults and peds..:)
We place Biopatch at the insertion site for all PICCs on day of insertion, EXCEPT for patients getting chemo immediately, eg, new leukemics who will start chemo that evening. Once the chemo is completed, the nurse is to change the dressing and put the Biopatch on. This allows the nurse to observe the site during chemo administration to see if their is any leakage/extravasation of chemo. I think IR is placing Biopatch on CVAD exit sites immediately after placement. MDs/PAs do not place biopatch at the time of insertion, but those nurses in critical care are supposed to change the dressing and add Biopatch at 24 hours. Biopatch has made a difference in our ICUs, and most recently in our oncology unit. I am convinced Biopatch makes a difference. It is of paramount importance, however, that maximum sterile barrier precautions be used, chlorhexidine skin antisepsis, etc.
We use Biopatch on all PICCs and CVCs. Most of the time we are applying the Biopatch at the time of insertion of the catheter, as it still works well in the presence of blood, and we rarely have any site bleeding.
At my new job (adult ICU) they are used on PICC's,central lines,HD catheters,art lines,traction pins. Some of the nurses call them "Maki patches"--had to chuckle when I heard that one!
Yes at the time of insertion of all central lines. Plus when new patients come into our facility with a central line, dressing changed and biopatch added. Adult patients.
At one hospital I work, they like to leave a gauze the first time... so one is not used, but then the dressing is changed within 24 hrs, then one is used.
I prefer to use one the first time, unless there is undue bleeding and I know the dressing will need a soon dressing change.
Putting one on in that case is no foul, but will be short lived and until the cost come down, our hospital prefers not to use then unless it is likely to be in use for several days due to an initial clean install without undue amounts of blood.
We use Biopatch on all PICC's at insertion and all subsequent dressing changes (every 7 days).
For some reason, the Infection Control Committee didn't approve them on all CVCs. We use CVCs with antibiotice protections for triple lumen subclavians and they think that is enough.
We use Biopatch on all CVCs including PICCs. Our Infection Control also tried to not put them on when they started using Triple Lumen CVCs that are impregnated with silver sulfadine. They did say that the protection is gone in 14 days and Silver doesn't have any skin affinity, so we continue to use Biopatch on ALL CVCs. You may want to check what your catheter is treated with too!
We are trying to use Biopatch for Port Access but are meeting some resistance. Our home infusion already uses it with Port Access. Karen
You will need to check what type of CVC your hospital has. If it has chlorhexidine and silver sulfadiazine on the internal, external surfaces including the extension legs and hubs, then you may not need a biopatch also, as the catheter will combat any potential infection. If your CVC does not afford this level of protection, you may want to consider using a biopatch in addition to the catheter.
Sounds like you're using ArrowGard Blue (AGB) or ArrowGard Blue Plus (AGB+) triple lumen catheters from Arrow. Just so you know, when the catheters were impregnated intraluminally and extraluminally (AGB+), the chlorhexidine/silver sulfadiazine catheter treatment was shown to have a protective effect far longer than 14 days. These catheters are far more effective than first generation AGB catheters. If you want more info I can get it to you. I just didn't want folks reading to think the effectiveness disappeared after two weeks.
Thanks, Jeff for the update. It may have been misunderstood by our Infection Control dept. I think eliminating Biopatch may have been suggested to defray the cost of the catheter. I'm just glad that we continue to use Biopatch to decrease microbial growth at the insertion site. Karen
We place a Biopatch over the site on the day of insertion if no bleeding and if they have fragile skin, where lifting the op-site may tear the skin, but in most cases the day after the insertion, when any bleeding from the insertion has stopped. We insert PICC lines on Adults.
We use biopatch 24 hours post insertion on all CVLs including PICCs - Pediatrics
Ingrid Lawson RN, BSN
PICC / Sedation Coordinator
Ingrid Lawson RN, BSN
PICC / Sedation Coordinator
We use bio patch here in Owensboro, we are using on all lines, including ports, just got policies finsihed. No problems so far with the product but still early to tell. We are putting on adults and peds..:)
We place Biopatch at the insertion site for all PICCs on day of insertion, EXCEPT for patients getting chemo immediately, eg, new leukemics who will start chemo that evening. Once the chemo is completed, the nurse is to change the dressing and put the Biopatch on. This allows the nurse to observe the site during chemo administration to see if their is any leakage/extravasation of chemo. I think IR is placing Biopatch on CVAD exit sites immediately after placement. MDs/PAs do not place biopatch at the time of insertion, but those nurses in critical care are supposed to change the dressing and add Biopatch at 24 hours. Biopatch has made a difference in our ICUs, and most recently in our oncology unit. I am convinced Biopatch makes a difference. It is of paramount importance, however, that maximum sterile barrier precautions be used, chlorhexidine skin antisepsis, etc.
Nadine Nakazawa, RN
PICC Nurse, Stanford Hospital
Nadine Nakazawa, RN, BS, VA-BC
At one hospital I work, they like to leave a gauze the first time... so one is not used, but then the dressing is changed within 24 hrs, then one is used.
I prefer to use one the first time, unless there is undue bleeding and I know the dressing will need a soon dressing change.
Putting one on in that case is no foul, but will be short lived and until the cost come down, our hospital prefers not to use then unless it is likely to be in use for several days due to an initial clean install without undue amounts of blood.
The second mouse gets the cheese!
We use Biopatch on all PICC's at insertion and all subsequent dressing changes (every 7 days).
For some reason, the Infection Control Committee didn't approve them on all CVCs. We use CVCs with antibiotice protections for triple lumen subclavians and they think that is enough.
I hope that changes soon.
Gwen Irwin
Austin, Texas
We use Biopatch on all CVCs including PICCs. Our Infection Control also tried to not put them on when they started using Triple Lumen CVCs that are impregnated with silver sulfadine. They did say that the protection is gone in 14 days and Silver doesn't have any skin affinity, so we continue to use Biopatch on ALL CVCs. You may want to check what your catheter is treated with too!
We are trying to use Biopatch for Port Access but are meeting some resistance. Our home infusion already uses it with Port Access. Karen
Karen McKeon Williford RN, CRNI
Hi Karen,
Sounds like you're using ArrowGard Blue (AGB) or ArrowGard Blue Plus (AGB+) triple lumen catheters from Arrow. Just so you know, when the catheters were impregnated intraluminally and extraluminally (AGB+), the chlorhexidine/silver sulfadiazine catheter treatment was shown to have a protective effect far longer than 14 days. These catheters are far more effective than first generation AGB catheters. If you want more info I can get it to you. I just didn't want folks reading to think the effectiveness disappeared after two weeks.
Jeff
Karen McKeon Williford RN, CRNI