Does anyone have any evidence they can offer to me in support of leaving gauze off the site of PICC insertion? I have a physician who insists gauze be applied, in spite of the fact we change the dressing every seven days. I cannot find anything other than INS Standards (e.g. studies, etc.). Any assistance you could offer would be very much appreciated. Thanks!
Eileen Martin
Cedars-Sinai Medical Center
I would first want to know what his rationale is for wanting the gauze left in place. What type of dressing are you using - transparent membrane it sounds like from the 7 day change interval. I would call the manufacturer of that dressing and get their specific instructions about the use of gauze. The company could have some information about the interruption of the oxygen exchange through the transparent membrane. But before I would go chasing wild gooses, I would want to know his rationale for this request. After reviewing all the evidence, I would then set the physician straight about hospital policy and procedure. I have been in several situations where one physician wanted things done differently on his patients. The IV team did not allow that at all. P & P goes through a proper committee. Their decisions apply to all situations and a physician can not alter a policy.
Lynn Hadaway, M.Ed., RN, BC, CRNI
www.hadawayassociates.com
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
Doesn't the CDC guidelines state that gauze dressing should be changed within 48 hours? So any gauze on the site qualifies as a gauze dressing, right?
I agree with Lynn. What is his rationale? We don't allow a physician order to override our policy.
Gwen Irwin
Austin, Texas