Re: 24 hour dressing after PICC insertion

[Heather Nichols]

Same here minus the Bio-Patch.   Heather Nichols RN BSN CRNI Infusion Services University of Louisville Trauma Institute 530 S. Jackson St. Lou. Ky. 40202 (502)562-3530 >>> "Helen Lazeration" <[EMAIL PROTECTED]> 7/21/2006 12:39 AM >>> Gwen,   I think that I do the 24 hour dressing because there is usually bleeding at the site some more than others and I don't like leaving that moisture on there.  Studies, I don't know about.  I think that the moisture of the blood against the skin and acting as a culture medium for bacteria growth seems to be an adequate reason for me to change the dressing.  I don't know about others but the first 24 hours we kind of bulk up the 2x2's over the insertion site as part of the pressure dressing and it is more comfortable for the patient if we can remove that at 24 hours. We occasionally leave one that looks dry and intact for 48 hours or the next routine dressing change if everything looks fine.  We do ours every 4 days because that what works for us with our central lines and we have an extremely low infection rate.  We also use biopatches on 100 % of our lines and I'm not sure that we don't loose some of the effectiveness if they are saturated with debris and moisture.    Hope this helps.   Helen Lazeration, CRNI Fairbanks Memorial Hospital Fairbanks, Alaska   -------Original Message-------   From: Gwen Irwin Date: 7/20/2006 6:15:59 PM To: [EMAIL PROTECTED] Subject: 24 hour dressing after PICC insertion   I have had a question posed to me about why a 24 hour dressing change after a PICC insertion is required.  The CDC's Guidelines to the Prevention of Intravascular Catheter Related Infections address gauze dressing used on CVCs (includes PICCs, right?) need to be changed every 48 hours.   So, why do we require a 24 hour dressing change?  Every PICC course that I have attended states this, but why do we do this?  I had to laugh when asked this question, because I almost said "That is what we have always done."  This kind of response is what I battle often for many other CVC practices (sound familiar?).  Is there evidence that the 24 hour dressing change for PICCs is necessary?  Is there any evidence that a 48 hour dressing change after insertion would change the patient's outcomes?   I value your perspectives and would enjoy hearing what you think.   Gwen Irwin Austin, Texas   ----------------------------------------------------- Confidentiality Disclaimer This message, including any attachments, is confidential, intended only for the named recipient(s) and may contain information that is privileged or exempt from disclosure under applicable law, including PHI (Protected Health Information) covered under the Health Insurance Portability and Accountability Act (HIPAA) of 1996.  If you are not the intended recipient(s), you are notified that the dissemination, distribution, or copying of this message is strictly prohibited.  If you receive this message in error, or are not the named recipient(s), please notify the sender or contact the University of Louisville Health Care I.S. helpdesk at 502.562.3637 to report an inadvertently received message. -----------------------------------------------------

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