Is anyone using a securement device for PICCs other than Statlock?Â We are looking at the Bone by Nexus Medical;Â Grip-Lok by Baxter; WingGuard by Centurion as well as the Statlock.Â
I know this is somewhat of a philosophical discussion, but I'm hoping someone has some answers for us.Â Our PICC department is one of the few(I hear)who still sutures.Â Our original PICC nurse was trained at M.D. Anderson in Houston, TX...where they still suture their PICCs.Â A nurse in the I.V. dept there told me they had done an in-house study that showed no increase in infection and fewer PICCs pulled out with suturing.Â So...we learned to suture from the very beginning.Â We are good at it and have very few patient complaints and very few inflamed sutures.Â We also have few infections.Â Â The PICC nurses don't do the dressing changes here.Â They are done by the staff nurses.
Â Our new infection control person and our new clinical services nurse quote INS standards and now say we must use a securement device and stop suturing.Â Our biggest concern is that the infection rate will go up and more PICCs become malpositioned or pulled out due the manipulation of the line during dressing changes.
Â Â Â I've done a lot of research in the literature on this subject.Â The only actual study I see comparing suture to securement devices is the one done by Yamamoto et al. reported in the 2002 ; 13:77-81 Journal of Vascular Interventional Radiology....funded by the way by Venetec who makes Statlock.
Â Other articles I read..including the one in Journal of Infusion Nursing quote that one article.Â The CDC MMWR of 2002 states that no recommendation can be made regarding sutureless securement devices...the Yamamoto study is "underpowered" and basically, more study needs to be done.
Â I'd like to know why INS standards prefers sutureless securement devices rather than having them as an option to suturing.Â This is so huge and is going to effect our practice here so much.Â It seems to me that the Statlock "people" are the ones pushing securement devices.Â I can really understand why PICC nurses who used to use steri strips or sterile tape for securement prefer the device.Â
Â I've asked if we could do an in-house study, but the powers that be seem pretty set that we are definitely going to securement devices.Â Do none of you have problems with "pistoning" on the catheter during statlock changes?Â