Our manager needs info on neonatal PICCs.
1. How often do you change PICC dressings on NICU patients? If not consistent with current INS/CDC guidelines( i.e q 7 days or if it becomes soiled/wet). Please give reference(s) for current practice.
2. How do you secure neonatal PICCs? Securement device vs suturing? Any skin breakdown issues with securement devices?
Thanks.
We change neonatal PICCs dressings at 7 days intervals or when the integrity of the dressing is compromised. There are some sites that do not lend themselves to easy dressing changes without compromising the line. Scalp and external jugular PICC are a bit nerve wracking to change so it is written into the policy that these dressings may remain as long as they are occlusive and dry with the insertion site clearly visible. This is reflected in the CDC guidelines for the prevention of CRBSI.
The decision to change the dressing then is made on a patient by patient basis.
We secure with steristrips at the catheter hub and a transparent dressing. No sutures and most securement devices are too large for some of the neonates and premies. Skin integrity can also be an issue with these patients so sutures would be too damaging and the less adhesive the better.