Central venous catheter care and maintenance guideline draft heparin use requires a physicians order central venous catheter page 5 of 7 catheters catheter flushing dressing reflux valve cap blood withdrawal needed to clear line nicu. Peripherally inserted central catheter dressing change. This makes me so nervous because when it rips, its fast. The end of this catheter goes into a large vein near your heart. Ensure edges remain together to maximize effectiveness dont place biopatch on wet chloraprep. Picc line carehow to care for picc lines in nursing clinical settings. Apply biopatch blue side up and with slit near the line. The allpoints dressing change systems picc, cvc, dialysis follow lean six sigma principles by providing standardized configurations, each designed for a specific central line procedure. Picc line dressing change with sorbaview shield dressing and biopatch.
Change font size to suit page 1 of 28 guideline peripherally inserted central venous catheters picc 1. For years, many patients receiving chemotherapy through a picc line in the outpatient chemotherapy clinic developed skin. Sterile dressing change change dressing 24 hours post insertion every 7 days hibiclens followed by chloraprep biopatch an antimicrobial dressing steristrips to secure site clear bioocclusive dressing change cap every 7 days or whenever removed. It is a long, very thin, flexible tube that is inserted into one of the large veins above the elbow.
Replace dressing when it becomes damp, loosened, or when inspection of the. If a biopatch is used the blue side should face up. Patient denies discomfort at site, or along vein track. More and more, nurses are caring for patients with picc lines both in hospitals and in the community and knowing how to complete a picc. Document the picc dressing change, clinical assessment of site and external measurement length. Does anyone charge separately for cvcpicc dressing change. Antiseptic coverage is delivered through a chgimpregnated gel incorporated into the dressing, which is placed over the catheter insertion site, and is intended to reduce skin and catheter colonisation, and hence the incidence of crbsi. Policy and procedure for picc line or midline catheter dressing change. It is important to learn how to maintain and clean the picc line and dressings, as well as flushing. Youll need to change your dressing often, so that germs dont get into your catheter and make you sick. How to properly clean the skin using betadine solution. Picc line care picc line dressing change clinical nursing skills. Site without redness, swelling or exudate, or any other ss complications.
Assess the dressing in the first 24 hours change for accumulation of blood fluid or moisture beneath the dressing. Have the patient turn their headaway from the area to avoid. Advice on the use of biopatch hydrophilic foam dressing with. A peripherally inserted central catheter picc is a long, thin tube that goes into your body through a vein in your upper arm. Central line dressing change a central line picc, port, hickman or other tunneled catheter dressing change is a sterile procedure. A portacath is a device that is usually placed under the skin in the right side of the chest. Use biopatch disk as part of a piv bundle to help protect the insertion site. To prevent external infection of the peripheral or central venous catheter. Effect of chlorhexidine gluconate on the skin integrity at picc line. There are many subtle ways a sterile surface can become contaminated, which puts you at risk for blood stream infections. A nurse or technician will show you how to change the dressing. This video shows how to change a picc line dressing. Does anyone charge separately for cvc picc dressing change.
A peripherally inserted central catheter is often called a picc line. Learn how to safely perform a picc dressing change, demonstrating how to apply and remove the tegaderm i. Dressings and securement products catheter site care. Wash the hands thoroughly with soap and water for a minimum of 15 seconds. Ethicon biopatch protective disk with chg catheteriv. Central venous access device dressing change protocol. One of the things you will encounter as a nurse is a picc line also called a peripherally inserted central catheter. Picc that is secured with an adhesive securement device. The dos and donts of biopatch dressing application do dont do apply biopatch after cleansing with chloraprep and allowing it to dry. Remove transparent dressing according to manufacturers instructions.
Picc line dressings are used to protect the picc line insertion site from outside contaminates such as fluids, dirt or microorganisms e. Sterile gloves these are put on in a special way after you have finished touching anything that does not have to be sterile. Do not try this procedure alone because you cannot do this with one hand and. After the first 24 hours the frequency is every seven days.
Picc line dressing change with sorbaview shield dressing and biopatch disk duration. Purpose this guideline has been developed as part of the icare intervention bundle for the management of intravascular devices ivds. The guideline will promote a consistent and standardised approach to management of picc. Follow your health care providers instructions on changing your dressing. Patient and family central line education completed when one is placed.
Clean the skin with the sponge and cleaning solution. We bill on our inpatients but have added statlock and biopatch in the kit. The iv team, nutrition support nurse, and appropriately educated rns and physicians will change dressing according to the following guidelines. The initial dressing after first 24 hours should have a gauze dressing just above. We recommend you check out their step by step picc line dressing guide with illustrations. Picc line dressings may also be used to secure the picc line to the patients skin to prevent displacement. The technology biopatch for venous or arterial catheter sites.
To prevent external infection of the peripheral or central venous catheter frequency. Improving skin irritation and dermatitis induced by. Upon first entering the patients room, disinfect your hands by washing with soap. Then routinely every seven days and as needed picc line dressing change kit should include. Biopatch an antimicrobial disc that is placed around the catheter site. Prise transparent wings off and remove the statlock. Airtight with sterile gauze and antibiotic ointment. Check your skin for redness, swelling, or any bleeding or other drainage around the catheter. Tegaderm chg is an alternative to transparent semipermeable membrane dressings referred to as standard dressings herein. The blue sticker on the biopatch sticks to the tegaderm and then i have been trying to rip the tegaderm to get that blue sticker off. Picc line or midline catheter dressing change purpose. Customized to clinician specifications and hospital protocol centurion dressing change trays set the standard in site securement and stabilization. Catheter has 2cm external which corresponds to previous external measurements.
Special considerations picc line dressing changes will use sterile technique. Picc line dressing change with biopatch and griplock griplok duration. Effect of chlorhexidine gluconate on the skin integrity at. I asked about biopatch and we dont use them as it hides the site. Tegaderm chg iv securement dressing for central venous and. Chloraprep, alcohol, biopatch disc, an occlusive transparent tegaderm dressing, and an optional statlock connectors should be change with each dressing change and as needed. How to avoid contamination, and open sterile items.
This change can lead to improved outcomes, increased efficiency, and better patient experience. Picc dressing change peripherally inserted central catheter for. Sterile dressing change procedure updated february 20 duration. Flush lines with 10 cc normal saline 20 ml for picc and midline following blood infusion or withdrawal prior to resuming infusion or perform appropriate flushing protocol if capped. The picc line dressing change process patient education at osumc. Centrallineorpicclinedressingchange medview systems. The procedure for flushing a picc will be described using antt aseptic.
Using the alcohol pads, lightly rub the pads over the patients old pads and dressing. Implement standard protocol verify md orders gather equipment explain procedure to the patient check for allergies check labs verify client and introduce yourself. Per sterile technique, area cleansed with xyz and allowed to air. I had my picc line change 14 times during my first 6 year stretch on tpn due to infections and blockages. I am doing these dressing changes by myself and have no trouble except for the biopatch. Peripherally inserted central catheter picc is an intravenous line placed into the patients upper arm to safely administer chemotherapy.
Packaging is color coded by device type for quick and easy identification. Place the biopatch dressing around the catheter, making sure the blue side is facing. At home you will need to change the dressing that protects the catheter site. Johnson and johnson biopatch protective disc with chg is an iv and wound dressing that provides a powerful antimicrobial and antifungal dressing. By utilizing a dedicated picc maintenance team and standardizing clabsi bundles, which included the prophylactic use of statseal in the dressing change protocol, the nicu was able to decrease the clabsi rate by 92%, equaling a reduction of 7 clabsi infections over 3 years. Medical action sets the industry standard for quality and reliability by incorporating stateoftheart systems with highly skilled professionals working together to provide you with a complete line of central line dressing change kits. Picc, port, hickman or other tunneled catheter dressing change is a sterile procedure. Remove the biopatch dressing from the sterile package using aseptic technique. The photo is an example of a picc dressing post insertion. Statlock a securement device that requires the wings of the picc line be. Peripherally inserted central catheter picc dressing. Mask used by the person changing the dressing usually not the patient. Biopatch antimicrobial dressing fenestrated disks, sterile. How to change a picc line dressing using sterile aseptic technique.
Peripherally inserted central catheter dressing change medlineplus. The central line dressings should be changed a minimum of every seven days. Prepare the skin surrounding the percutaneous device according to hospital protocol. It is attached to a catheter a thin, flexible tube that is threaded into a large vein above the right side of the heart called the superior vena cava.
You will need to change it sooner if it becomes loose or gets wet or. Featuring centurion dressings and securement products that provide proven site and catheter protection for up to 7 days, trays are customized to the specific needs of clinicians and hospital protocol. Peripheral ivs are the most frequently used invasive device in hospitals, 6 and standards of care now recommend clinically indicated replacement. Skin erythema immediately after chg application picc insertionwas directionally increased p 0. May utilize adhesive tape remover to remove dressingadhesive tape non. These features allow the biopatch dressing to inhibit bacterial growth. We charge a kit fee through order entry in our meditech module in the. Gather the necessary materials biopatch, alcohol wipes, plastic wrap or aluminum foil, soap, and dressing kit. Instead of creating storage space for numerous items which are pulled repeatedly for similar procedures, a wolf medical dressing change kit conveniently holds all your important components in one. Place a new biopatch over the area where the catheter enters your skin. Place biopatch so precut slit is oriented near or under the catheter, facing toward end of the catheter. Picc line dressing change with sorbaview shield dressing and. I am changing the dressing every 24 hours, alternating the cover over the picc line between the biopatch and 2 x 2 sterile no tegaderm, just a 4 x 4 sterile lightly taped with the nexcare waterproof on the corners.
1386 54 252 210 1317 369 417 544 1531 54 1070 1625 862 1200 613 662 144 1577 405 1334 298 212 651 618 490 685 899 113 512 282 389