[rhaugen]

Hello all, I'm new here however I wanted to ask some questions of practicing nurses about OSHA, CDC and NAPSSI, and INS recommendations for the use
of IV securement devices in an effort to reduce the incidence of accidental
needlesticks.

Have you used any of the IV securement devices out there?

Do you find these devices to extend the dwell time of IV's?

Does your administration mandate their usage?

Any comments or feedback would be greatly appreciated.

Rick

[SoldierNurse]

Hello Rick,

Do you work in the healthcare field? If so, at what capacity?

[rhaugen]

I represent a company that is developing an IV securement device. We would like to understand what health care workers view on securement devices is and how recent legislation is viewed.


Rick

[Ricu]

Hi folks,

For some reason, I have a hard time with the term, "IV securement device." I know what the term refers to but I've never said "securement" before. Are we talking about the ageless "chevron" taping process or one of the many Tegaderm and foam tape contraptions, or both? My personal favorite is just a small Tegaderm applied over the site and covering only the catheter. This allows direct view of the insertion site and minimizes what needs to be taken down when and if the IV needs to be redressed. I hate struggling with a lot of bloody tape. No particular catheter securing procedure is required by my institution but we are diligent about q-shift flushing of ports not in use, especially in the ICU. I think this more than anything prolongs dwell time. I like to use extention sets on IV catheters too because I think it minimizes excessive movement of the catheter itself during intermittent access which I believe, reduces IV catheter life too. In short, I have no personal preference for "securement devices," only good insertion technique and careful maintenence. Thanks for asking, Rick.

R

[rhaugen]

IV Securement refers to an emerging concept that is backed by numerous studies that manufactured IV securement devices can prolong the IV dwell time. Tape, as you mentined is the most commonly used type of device right now, in particular the Tegaderm IV site dressing manufactured by 3M.

Tegaderm is a wonderful product and works for short term IV's very well, however it does not offer long term securement and certainly cannot offer securement up to the 96 hour dwell time, suggested by OSHA/CDC.

Recent studies suggest that the use of manufactured IV securement devices can not only prolong IV dwell times securely but they also carry the benefit of reducing accidental needlesticks by reducing the number of IV restarts.

Your exactly right in regard to movement of the catheter. If the movement of the catheter can be limited, or eliminated you can greatly extend the IV dwell time and that is exactly what IV securement devices offer.

There are lots of published studies showing the benefits of IV securement devices and in fact OSHA/CDC are now recommending their usage. These studies further show that tape can be contaminated and it's use as a securement device is now greatly discouraged.

Rick

[Ricu]

Originally Posted by rhaugen

IV Securement refers to an emerging concept that is backed by numerous studies that manufactured IV securement devices can prolong the IV dwell time. Tape, as you mentined is the most commonly used type of device right now, in particular the Tegaderm IV site dressing manufactured by 3M.

Tegaderm is a wonderful product and works for short term IV's very well, however it does not offer long term securement and certainly cannot offer securement up to the 96 hour dwell time, suggested by OSHA/CDC.

Recent studies suggest that the use of manufactured IV securement devices can not only prolong IV dwell times securely but they also carry the benefit of reducing accidental needlesticks by reducing the number of IV restarts.

Your exactly right in regard to movement of the catheter. If the movement of the catheter can be limited, or eliminated you can greatly extend the IV dwell time and that is exactly what IV securement devices offer.

There are lots of published studies showing the benefits of IV securement devices and in fact OSHA/CDC are now recommending their usage. These studies further show that tape can be contaminated and it's use as a securement device is now greatly discouraged.

Rick

Hi again, Rich,

Thanks for the information. I guess I don't know enough about OSHA regs regarding IV securement. I think we agree that tape is no longer the ideal but what is the nature of the product that your company is working with that makes it superior to say, Tegaderm, for minimizing catheter movement while optimizing infection control?

R

[cassioo]

My hospital started using some foam dogbone looking thing that works ok it does stick really well to your gloves. The tegaderm, opsite, clear film whatever name goes right on the site. I still chevron the hub. Dwell time in general isn't a problem for my unit 24 hrs is usually the longest time we need a site. Our hospital still have a 72 hr time on IV sites and they are only not changed with a MD order

[rhaugen]

We understand that because nurses have tried to "chevron" the catheter itself to the skin in an effort to minimize the movement of the catheter itself, that therein lies the problem.

As discussed tape fails typically after a short time.

Our product in contrast anchors the catheter to the skin of the patient
completely eliminating movement of the catheter. This is accomplished
with our patented compound that is literally peel and stick technology.

Initial testing has shown that we can sustain securement of the catheter,
and lead tubing for 96 hours and beyond.

In terms of infection control, the compound is created with an anti-microbial
substance within it that adheres to the skin and catheter, and
has been very effective in eliminating infections associated with resistant bacteria on the skin and catheter itself.

In terms of an outright comparison to Tegaderm our product is much more comfortable to the patient and allows removal and reapplication if necessary
without degrading it's adhesive qualities. Additionally Tegaderm typically will not adhere more than 24 hours.

Rick

[rhaugen]

Originally Posted by cassioo

My hospital started using some foam dogbone looking thing that works ok it does stick really well to your gloves. The tegaderm, opsite, clear film whatever name goes right on the site. I still chevron the hub. Dwell time in general isn't a problem for my unit 24 hrs is usually the longest time we need a site. Our hospital still have a 72 hr time on IV sites and they are only not changed with a MD order

You may be referring to the Statlock IV Securement device, but not sure. Tegaderm is still in essence a piece of tape that will fail within 24 hours, which as you mentioned is your general dwell time.

For the applications that run longer there is definitely an cost and operational advantage to a product that will allow you to get to the 72/96 hour dwell time.

Rick

[Ricu]

Originally Posted by rhaugen

You may be referring to the Statlock IV Securement device, but not sure. Tegaderm is still in essence a piece of tape that will fail within 24 hours, which as you mentioned is your general dwell time.

For the applications that run longer there is definitely an cost and operational advantage to a product that will allow you to get to the 72/96 hour dwell time.

Rick

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