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KPater
Skin Prep

Can you all tell that I have some much-needed administration time??   :o)

What is everyone's opinion on skin prep?   Do you use it?   How big of an area do you apply it to - just around the edges or as much of the area surrounding the insertion site as possible?

 

Thanks, Kelly

Alma Kooistra
We cleanse an area at least
We cleanse an area at least as large as will be under the dressing.
jung yae kim
skin prep

We use Chlorapreps for the Skin prep of PICC insertion.

Using Chorapreps, we prep about 6-8 inches around the intending insertion site for 30 seconds and wait for another 30 seconds to dry the prep area completely. If the skin surface is wet, then it takes for 2 minutes to  apply. I believe this is the manufacture guideline.

It is very important to prep the skin properly to get rid of normal skin flora as much as possible to decrease  chances of  catheter related bloodtream infections. Many patients who have acquied  infections  in  hospitals might get them from their own skin flora.

Susan S
I think she was asking about

I think she was asking about "skin prep" as in the barrier film, not the skin cleansing step.

    I use the skin prep that comes with the STATLOCK PICC-plus device.   I put it all around where the dressing will be once the Chloroprep has dried.   Depending on the dressing and the patient, I have at times also applied the skin prep around the edges of the tegaderm-type dressing once it has been applied.   I started doing this in when I worked in home health as the other more experienced nurses told me it helped to hold the edges down better.   Being this was in home care, i did not see the patient again for a week, the dressing did usually stay intact with some loosening around the edges.

Susan Schuetrumpf, RN, CRNI, VA-BC
Atlanta GA

Gwen Irwin
It must be an area larger

It must be an area larger than the transparent dressing for dressing changes, in my opinion.

It must be an area much larger than the fenestrated drape opening for PICC insertions. We probably do an area about 6x6 for insertions.

Gwen Irwin

Austin, Texas

Kathy Hartman
When preparing the skin,you

When preparing the skin,you should always apply the cleansing agent larger then the dressing being applied. If you are using a 4x4 tegaderm, clean an area 6x6.

It is critical to allow the cleansing agent to completely dry. If not, the chemicals in the tegaderm will leach into the skin when it comes in contact with the wet cleansing agent. This places the patient at risk for a skin reaction, such as a contact dermatitis.

Kathy

Kathleen Hartman, RN BSN

KPater
Susan was right - I am

Susan was right - I am asking about the actual "Skin Prep" - the barrier film, not cleansing the site.

Since that has been clarified, could I get answers to my original questions?  They come in our dressing change kits, however we have found that many do not use them, even when a patient has a reaction.  For more tender skin, some use Primapore - but, it's not transparent and I have found that this dressing is even more painful to remove when the skin prep is not used.

Thanks,

Kelly

lynncrni
I would never apply any type
I would never apply any type of tape, securement device or TSM dressing without using some brand of skin protection solution. I believe in this stuff that strongly. It definitely protects the skin while maintaining an intact dressing. I have used it on myself and would never allow any dressing on my skin without its use. It prevents skin breakdown so you do not have to spend valuable time and resources on healing skin irritation. I would always use it and always include it in each class I teach. Lynn 

Lynn Hadaway, M.Ed., RN, BC, CRNI

Lynn Hadaway Associates, Inc.

126 Main Street, PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

AMParry
We use the skin barrie swab

We use the skin barrie swab sticks that come in our dressing change kit - applying to the area coverd by the dressing but avoiding the catheter itsself.  If needed we use the NO STING barrier by 3 M -for really sensitive or problem skin areas

Ann Marie

Ann Marie Parry, RN, CRNI, VA-BC

amparry@geisinger.edu

KPater
Great, that's the kind of

Great, that's the kind of information I'm looking for.  Thank you Lynn and Ann.  Now, my next question for you is where can I find data or information to back this up?  I recently discovered that a few of my coworkers did not use this and didn't agree with my rationale to use it.  I did get some info on the product from a website, but I wondered if anyone had a policy regarding it.  Thanks!  Kelly

Leigh Ann Bowegeddes
I use skin prep under all
I use skin prep under all adhesives. It lays down an acrylic layer to protect the skin. It also helps make dressings stick better. I apply it over the entire area that the dressing and StatLock will cover. I just learned today from the Smith-Nephew rep that if I go over the dressing edges with skin prep after the dressing is in place, it helps seal the dressing down and helps keep the edges from peeling up.
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