A couple of thoughts: The Statlock foam does not allow the skin to
"breathe", but will trap moisture under it. Therefore if the Statlock
could be placed at least 1 cm away from the exit site, that would be better.
Secondly, the excess PICC can and should be stabilized with a second
Statlock nicely curved on the skin so that at least the blue part and the
hub are under the dressing. It isn't bacteria from the air that are causing
CRBSIs, but growth of the patient's own skin microflora that migrate down
that catheter track.
Yes, the dressing needs to be intact so that the exit side isn't exposed,
but the dressing will not lie completely flat against the skin if you use
Statlock and/or Biopatch. There will be some parts of the dressing that are
raised.
Nadine Nakazawa
From: "Kelly Murphy" <[EMAIL PROTECTED]>
To: [EMAIL PROTECTED]
Subject: Occlusive Dressing
Date: Wed, 11 Oct 2006 05:53:28 -0700 (PDT)
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
cthatatheter, 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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