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Jo Faux
Implanted Port Dressings

What is your policy for dressing changes when sterile gauze 2x2's are placed under the wings of the non-coring needle and a transparent dressing placed over the needle, wings and gauze?  We have a policy that states the transparent dressing must be changed every 48 hours if gauze is under the dressing, but in actual practice, the dressing is changed every 7 days.

I would like to hear how others treat this situation.

 

Jo Faux

Hermiston, OR

nancy riley
According to INS standards,
According to INS standards, when there is a guaze  in place, even under a transparent dressing, it is considered a dry, sterile dressing and should be changed every 48hr.  One reason guaze is used with  port non coring needles, is that the appropriate needle size has not been used and is not sitting  flush with the port/ skin, thus making it prone to dislodgement, etc.  Also, when this guaze dressing is in place it is not possible to assess the site.  Changing the guaze dressing every 48hrs. can also cause movement of the port needle and thus result in medications not infusing into the port resevoir.
lynncrni
Nancy, please check the 2006
Nancy, please check the 2006 INS standards. We changed this language regarding using gauze to pad the wings of a port access needle. We felt it was far safer to have the wing supported than to risk needle dislodgement. So you can pad the wings now with gauze or the shims provided by the needle manufacturers without worrying about it being a 48 hour dressing change. 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

It states in the 2006

It states in the 2006 (Jan/Feb) INS standards:

If a gauze is used to stabilze the access needle (under the TSM), but not obscure the catheter-skin junction, the drsg is NOT considered a gauze drsg and should be changed at least every 7 days.

So, fold the 2x2 in half and use it just to stabilize the wings and provide pt comfort.

 

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