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JudyThompson
24 Hour Dressing Changes

Hi all -

For those of you placing a Biopatch at the time of insertion, are you routinely doing a 24 or 48 hour dressing change?  At my facility, we routinely change the dressing every 7 days.  I'd like to know what the "community" at large is practicing.

(I changed our policy over 2 years ago, My hospital management is inquiring why we no longer perform 24 hour dressing changes)  I believe there is good evidence to back this practice up as well as substantial cost savings.

Thanks in advance for your help.

valoriedunn
If there is no gauze and a

If there is no gauze and a biopatch we do not do the 24 hour after insertion dressing change.

Valorie Dunn, RN, BSN, CRNI

Infusion Therapy Coordinator

Home Health Pharmacy

St. Elizabeth Regional Health

Valorie Dunn,BSN, RN, CRNI, PLNC

DCrni
We also changed our practice

We also changed our practice a few years ago.  We only apply guaze if there is active bleeding.   We just try to take the extra time to achieve hemostasiis before applying the dressing. It is hard to resist the temptation to slap on a gauze dressing in order to run to the next picc insertion.

 

Darilyn Cole, CRNI

PICC Team

Mercy General Hospital

Sacramento, CA

Darilyn Cole, RN, CRNI, VA-BC
PICC Team Mercy General Hospital Sacramento, CA

 

msiegelrn
Dressing change

I agree that as long as there is no gauze being used, the site is clean and dry of any blood or discharge and a biopatch is in place and intact beneath a TSM dressing then once a week, no longer than 7 days, is appropriate. As Darilyn said if you take care at the time of insertion then there is no reason to change a dressing in 24 hours. Sometimes old habits, such as post-insertion 24 hour dressing changes, are hard to break or change but we must move on. 

Marvin Siegel RN CRNI

Director of Clinical Services

Town Total Health

NY, NY

Gina Ward
24 hour dressing

 

We used to always place gauze and then transparent dressing over picc site for post insertion bleeding.  What I found was that I was doing alot of 24 hour dressings and the dressing was clean and dry.  I decided to assess each insertion upon completion and determine which one would benefit from a gauze dressing and which one could have a biopatch.  The reason you do the 24 hour dressing is because of the gauze dressing and the blood on the site.   I also felt that any unecessary dressing change was exposing the patient to an increase risk of infection.  I found this to work out great.  It has saved me so much time.  I always go and assess every picc line 24 hours after to insertion  ( next day) .  If it is clean and biopatch, great, if not I change it. 

Gina Ward R.N., CPAN

Gina Ward R.N., VA-BC

lynncrni
The 24- hour dressing change

The 24- hour dressing change with PICCs actually began due to the technology being used in the early days. The insertion needles were very large compared to the PICC itself. This meant lots of bleeding for some patients. Thus the need to change the dressing within 24 hours. That is no longer the case with MST insertion. So you simply need to alter your practice based on this change in technology. No blood means no need to change the dressing. 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

JudyThompson
Thanks for the input

Thanks for the input everyone.  I appreciate it.

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