What is the best way to achieve a truly occlusive
dressing?  We have two issues that make us question if
you can ever get a truly occlusive dressing. . .
the first is one that will be eliminated when we
finally convert to inserting Power PICCs only.  Right
now, we use Groshongs and when there is extra
catheter, what is the proper way to ensure
occlusiveness (is that a word?).  I try to make sure
that all extra catheter remains under the dressing. 
Others have used 2 statlocks and left some of the
catheter  and the second statlock hanging out of the
dressing.  I don't like this practice for fear of the
patient pulling it (which they will), but was
wondering if there was a protocol.
Secondly, when I use a statlock, I try to put it as
close to the insertion site as possible, hoping to
anchor it more securely.  Others will put it a little
further away and then the edge of the dressing goes
over part of the statlock, but the entire statlock
isn't covered.  In fact, half of the clip is exposed. 
This makes for a dressing that is not "air-tight" and
hence could let bacteria in.
I know the answers to these questions already, but
just wanted a little back-up for when I present it to
my coworkers.
Thanks!
Kelly

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