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mamirhekmat
maximum sterile barrier

At our hospital , we have an almost zero infection rate when it comes to placing piccs.  As for maximum  sterile

barrier, we have an option of using the "throw away ", "very bulky" drapes that a certain company is supplying

us. The cost happens to be prohibative, the drape costs 3x as much as our sterile towels and other sterile drapes

that we use. Some of us also  find the "throw away" drape very cumbersome to use.  My question to all those

who practice maxium sterile barrier, what do you use?  

Maureen , RN,CRNI

mharman
Maximum Sterile Barrier

We have a custom PICC kit that includes 4 "paper" drapes.  There are 2 small square (one for under the arm and one for the head of the bed), 1 fenestrated (for the arm) and a full length body drape. 

Mally Harman, RN, BSN
Vascular Access Team Coordinator
Centra Health
Lynchburg, VA
434-200-2647

Michelle Todd CRNI
I use a full body drape from

I use a full body drape from medline DYNJP4117 cost about $10

I prefer the drape you are likely talking about for about $35 but the Medline drape for $10 is just fine.

Michelle Todd, CRNI--Head PICC Nurse, Vibra Specialty Hospital of Portland [email protected]

mary ann ferrannini
 We use one by Microtek...it

 We use one by Microtek...it does say on it that it is a PICC insertion drape...and it most certainly covers from head to toe and then some...we tent it with some Kelly clamps on the very edge to keep it off the pts face... I think we pay about 9 dollars or so for it

Robbin George
We use the Kimberly-Clark U

We use the Kimberly-Clark U Drape at a cost of less than $6 per unit

It is used in the OR to drape patients for knee surgery but the single opening adapts perfectly to the arm

Thanks to our friends at Walter Reed for the suggestion

Robbin George RN VA-BC

Rhonda Wojtas
max barrer

The definition of max barrier is very clear. A one peice fenestrated drape that covers the patient head to toe. We use the Bard Max Barrier product.

Rhonda Wojtas, RN VA-BC

Gwen Irwin
Max barrier

I don't think what I looked made it very clear for the drape to be one piece fenestrated drape.  The article that the IHI referenced definitely wasn't one piece.

If you have a reference, can you provide it?

Gwen Irwin

Austin, Texas

Kathleen M. Wilson
Does anyone have an answer to

Does anyone have an answer to the last question posted here? The question was where is it stated that max barrier for PICC insertion dictates one piece, head to toe, covering head?

And, is anyone using a three piece with mask/cap on patient, and do you think that is compliant?

Thanks, Kathleen

Kathleen Wilson, CRNI

Dan Juckette
Neither CDC nor INS seem to

Neither CDC nor INS seem to mandate that the drape be fenestrated. It needs to be a large full body drape. However, fenestrated drapes are mandated for similarly invasive procedures like arterial lines and generally used in surgicalprocedures perfiormed outside the surgical suite.

I have been using the CDC definition of maximum barrier precautions in my practice for twenty years. I have seen it go from ridiculed as unnecessary and wasteful to an intresting idea to standard of care. Similarly, my maximum barrier supplies have gone from cloth drapes I took from OR supplies to paper that was sterile but not impermiable, to packaged drapes that were sterile and impermiable. I had to assemble my supplies from throughout the hospital every time I did a line and thought I was living the good life when I hit upon keeping some stashed in a rolling suitcase to save a few steps.

Now, I have all of my maximum barrier supplies in a kit, and a cart to keep them in to take them to the bedside. So, to me, this sounds very much like a debate over cloth versus disposable diapers. It is debatable whether cloth uses less resources than disposables. If you have the time and inclination to launder and sterilize them, feel free. But, I am not going back to cloth diapers or to assembling my own maximum barries supplies. My labor costs far offset any pennies saved by collection them myself.

Daniel Juckette RN, CCRN, VA-BC

Saharris
What is max barrier

I thought this might be helpful
IHI definition of Max Barrier:
“For the operator placing the central line and for those assisting in the procedure, maximal barrier precautions means strict compliance with handwashing, wearing a cap, mask, sterile gown and gloves. The cap should cover all hair and the mask should cover the nose and mouth tightly. These precautions are the same as for any other surgical procedure that carries a risk of infection.
"For the patient, maximal barrier precautions means covering the patient from head to toe with a sterile drape with a small opening for the site of insertion.”

I interpret this as meaning a fenestrated drape. I realize there are probably different interpretations(although I would say the "four paper drapes" comment is probably woefully inadequate! If you read the definition above from IHI it does not say cover the patient with head to toe drapes plural but drape singular.

Stephen Harris RN, CRNI, VA-BC
Chief Clinical Officer
Carolina Vascular Wellness

Saharris
Oops I apologize i just

Oops I apologize i just reread the comment about the four paper drapes and see there is a full length drape which I did not see originally, sorry!

Stephen Harris RN, CRNI, VA-BC
Chief Clinical Officer
Carolina Vascular Wellness

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