IV Securement devices

[rhaugen]

Hi again, Rick,

I like the sound of a product that can be removed and restuck without loss of integrity. The added antimicrobial property is also compelling. What have been your research findings on the best preinsertion site prep? Additionally, I'm wondering if the per unit cost of this kit may make it more appropriate for use on IJ,SC or PICC lines which have a longer anticipated dwell time. Contrary to what seems to be your findings, my experience has been that a properly placed Tegaderm product typically lasts a lot longer than 24 hours.

R

Dr. Dennis G. Maki, MD professor of medicine and head of infectious disease at the University Wisconsin-Madison Medical school has said that Chlorhexadine should be used whenever available as the preferred skin prep solution.

Most studies (not ours) in which Tegaderm was tested with IV Securement devices have shown the Tegaderm product to fail within 48 hours vs IV securement devices.

Most institutions right now change the IV's every 72 hours because they do not have any means by which they can extend the IV to the maximum 96 hour dwell time.

I would agree with you that central lines, SC, or IJ, are all typically longer term IV proceedures whereby cost may become a factor, however right now
hospitals are not able to bill for Tegaderm, or tape when seeking reimbursement from insurance companies, so obviously they are seeking the lowest cost solution available.

Conversely if a product were made available that would reduce infections, increase dwell times to the CDC/OSHA guildelines of 96 hours, and the hospital could bill any insurace for reimbursement, the cost would of the product would no longer be an issue, particulary if the product were easier to use, and more comfortable for the patient, and reduced incidence of infection.

Rick

[Ricu]

Dr. Dennis G. Maki, MD professor of medicine and head of infectious disease at the University Wisconsin-Madison Medical school has said that Chlorhexadine should be used whenever available as the preferred skin prep solution.

Most studies (not ours) in which Tegaderm was tested with IV Securement devices have shown the Tegaderm product to fail within 48 hours vs IV securement devices.

Most institutions right now change the IV's every 72 hours because they do not have any means by which they can extend the IV to the maximum 96 hour dwell time.

I would agree with you that central lines, SC, or IJ, are all typically longer term IV proceedures whereby cost may become a factor, however right now
hospitals are not able to bill for Tegaderm, or tape when seeking reimbursement from insurance companies, so obviously they are seeking the lowest cost solution available.

Conversely if a product were made available that would reduce infections, increase dwell times to the CDC/OSHA guildelines of 96 hours, and the hospital could bill any insurace for reimbursement, the cost would of the product would no longer be an issue, particulary if the product were easier to use, and more comfortable for the patient, and reduced incidence of infection.

Rick

Our institution has been using chlorhexidine for several years so it's good to learn that it's currently rated so well. I see how making the IV securement device a billable item could potentially eliminate the cost factor as an issue when using the product for all IV catheters. I will ask our unit rep to the new products committee to suggest trialing IV securement devices. Good luck and thank you for sharing your time and information.

R

[singingtothewheat]

I've been a nurse for 17 years. I now work on a very busy Ortho/Surg floor in a trauma center. Our hospital uses the stat lock / tegaderm products and I'm pretty pleased with that. When you stack it up against the whole Chevron securing method my personal opinion is that the Stat lock walks away the leader. I'm always amazed to see / hear nurses say they prefer to tape an I.V. site the old fashion way. It isn't beneficial to the patient no matter how used to doing it those nurses may be.
Having a product like that which would also limit risk of infection would be fabulous! Unfortunately (?), healthcare is a business and if any company wants to sell it's product wide scale it better beat the compatitions price, or have hard clinical evidence that it will save the system money by reducing risk.

On a side note about I.V.'s. Just wanted to remind nurses that any patient you get who had a field placed (I.V. placed at the scene or on the way to the hospital) needs a new I.V. placed immediately once stabalized. Field sticks are associated with much greater numbers of infections.

[rhaugen]

I've been a nurse for 17 years. I now work on a very busy Ortho/Surg floor in a trauma center. Our hospital uses the stat lock / tegaderm products and I'm pretty pleased with that. When you stack it up against the whole Chevron securing method my personal opinion is that the Stat lock walks away the leader. I'm always amazed to see / hear nurses say they prefer to tape an I.V. site the old fashion way. It isn't beneficial to the patient no matter how used to doing it those nurses may be.
Having a product like that which would also limit risk of infection would be fabulous! Unfortunately (?), healthcare is a business and if any company wants to sell it's product wide scale it better beat the compatitions price, or have hard clinical evidence that it will save the system money by reducing risk.

On a side note about I.V.'s. Just wanted to remind nurses that any patient you get who had a field placed (I.V. placed at the scene or on the way to the hospital) needs a new I.V. placed immediately once stabalized. Field sticks are associated with much greater numbers of infections.

Hey Everyone:

I've not been here in awhile as my firm has been showing the new IV securement device around the country with great feedback from Statlock users and died in the wool tape users.

Since I started this thread almost 2 years ago a lot has transpired in the industry and the number of CRBSI's and Staph infections has gone through the roof. From a legal standpoint the numbers of lawsuits against hospitals where a patient has been injured or died as a result of some form of infection, particularly Staph infection, is mounting and is really going to impact the industry.

Staph is a huge problem, and it is everywhere in the hospital. Catheters are now shown clearly to be infected by the healthcare worker with Staph, due to the environment. This means that it is clearly necessary to apply a dressing/securement device over the catheter that offers some type of anti-microbial to kill the contamination placed by the healthcare worker.

To your point singingtothewheat, we have been working with first responders and they are in fact changing their thinking about IV's, how to dress them, securing them against infection, etc.

In fact they are now seriously considering changing they way they teach all new EMT's and moving away from the tape and gauze technique to our peel and stick technology similar to Tegaderm, only easier to remove and restick, and offering an anti-microbial.

I would like to offer samples to anyone who would like to try them, simply respond here within this forum and I'll be glad to send sample for your review. Obviously we would like to hear your feedback so please don't request samples if your not willing to give us some feedback.

Thanks


Rick