Picc line care picc line dressing change clinical nursing skills. Do cover biopatch dressing with a bioclusive dressing and date it. Biopatch allergy, central line, chlorhexidine allergy, iv, ph, picc line, pulmonary hypertension, tegaderm allergy this topic has 0 replies, 1 voice, and was last updated 11 months, 4 weeks ago by colleen steele. Picc stands for peripherally inserted central catheter. Centurion dt7095bp dressing change tray picc line, fully. I had my picc line change 14 times during my first 6 year stretch on tpn due to infections and blockages.
Biopatch is applied to the insertion site before, and in addition to, applying a standard sterile transparent semipermeable iv dressing. Peripheral ivs are the most frequently used invasive device in hospitals, 6 and standards of care now recommend clinically indicated replacement. Use of biopatch for central line dressings at mgh biopatch is a chlorhexidine chg impregnated sponge dressing that is placed at the insertion site of central venous catheters. This guideline provides recommendations regarding best practice for the use and management of invasive devices based on current. Picc line dressing change biopatch shows how to set up the new dressing change tray kit in a sterile way with basic and custom supplies and remove old dressing on a picc line. Purchasing a prepackaged tray reduces the need for staff having to make separate purchases to obtain all the equipment. Picc line carehow to care for picc lines in nursing clinical settings. Common applications include iv catheters, other intravenous catheters and percutaneous devices. The dressing change tray picc line is a prepackaged kit fully equipped with industry standard instruments for the use of changing a peripherally inserted central catheter dressing on a patient the trays can be customized to fit your medical facilities needs. How to use biopatch to protect the insertion point. Prepare and clean the skin site with an alcoholic chlorhexidine solution containing a concentration of 0. The old dressing must be removed before applying new picc line dressing so nurses must make this the first step of the changing process.
Improving skin irritation and dermatitis induced by. Centrallineorpicclinedressingchange medview systems. Your nurse will teach you how your dressing should be changed. These infections can be very serious, and even life threatening. This change can lead to improved outcomes, increased efficiency, and better patient experience.
There are many subtle ways a sterile surface can become contaminated, which puts you at risk for blood stream infections. Thoroughly cleanse and dry the location you will be applying the biopatch. You could bill an em for the dressing change unless it is during the global period of a surgical procedure then it would not be billable. Assess the dressing every shift to ensure it isnt dirty, wet, or peeling off. When applying biopatch dressing to a patient, the first thing you will want to do is to prepare the insertion site. Apply biopatch blue side up and with slit near the line. Apsic guide for prevention of central line associated. Guideline peripherally inserted central venous catheters picc 1. Clinical evidence to support the efficacy of biopatch. Picc line dressing issues home iv and tube feeding inspire.
Picc line dressing change with biopatch and griplock griplok duration. Case control cvc picc 32 chlorhexidine dressing for reduction in microbial colonization. Dressing change tray peripherally inserted central catheter dressing change tray, picc line 50cs cnturn. You need to change it sooner if it becomes loose or gets wet or dirty. When using biopatch dressing or other chg impregnated dressings with. I have even used it on patients that react to chlorhexidine. A peripherally inserted central catheter picc is a long, thin tube that goes into your body through a vein in your upper arm. Statlock piccline care cleaning and changing home iv. For easy removal place slits to wards end of catheter and if bio patch sticks use normal saline dont apply biopatch dressing with the white foam side facing up. The data suggest that use of biopatch disk adds considerably to a clab reduction bundle and reduces infection costs. The picc nurse places fresh mastisol around the site, recoils the picc line, and places a new transparent dressing. I understand the disks are appropriate for 7 days, but i feel it is important to assess the site sooner than a week. I asked the company why these patients can tolerate this dressing, but react to other forms of chlorhexadine chloraprep and biopatch.
Clean the work area with alcohol pads or soap and water to sterilize the work area. Picc line dressing change with biopatch and griplock griplok. Picc line dressing change biopatch shows how to set up the new dressing change traykit in a sterile way with basic and custom supplies and remove old dressing on a picc line. A picc line peripherally inserted central catheter is a soft plastic tube that lasts much longer than the standard iv because the tip goes in a very large vein just above the heart. Contamination of the catheter hub is the most common source of bsis. If you notice that biopatch dressing has been applied with the white side up, change it. It is also indicated for control of surface bleeding from percutaneous catheters and vascular. It is important to learn how to maintain and clean the picc line and dressings, as well as flushing.
There is no manufacturers prohibition against use on tunneled catheters, however the renal service. Purpose this guideline has been developed as part of the icare intervention bundle for the management of intravascular devices ivds. Many patients require the use of a peripherally inserted central catheter picc as they continue to heal. The biopatch is good for 7 days if it is dry and intact.
This allows for full contact with the skin and chg at the insertion site. Picc line dressing change with sorbaview shield dressing and biopatch disk. Along with the skin, the actual lumens of a tunneled central or picc line is scrubbed during a dressing change. I use this dressing on patients that cannot tolerate traditional transparent dressings. Providing enough room for biopatch dressing will allow for proper skin antisepsis at each dress ing change. Our picc dressing kits come with alcohol swabs, chlorahexadine, skin protectant, the dressing itself and a catheter stabilization device. After a few years on tegaderm my husband developed an alergy to it and we switched to iv3000. Biopatch should be replaced at the time of the central line dressing change or if the patch appears saturated. When i had to back to tpn 4 years later they couldnt insert the line in my left arm. Demonstration includes how to clean the picc line site in a sterile way and then put a new dressing on it. It provides continual antisepsis over 7 days, thus preventing skin organisms from entering at the insertion site and tracking extraluminally up the catheter and into the bloodstream. The picc line dressing change process patient education at osumc.
Biopatch ethicon is composed of a sterile polyurethane foam dressing impregnated with chg, an antiseptic used in the sterilisation of insertion sites before catheter insertion. This video shows how to change a picc line dressing. Gather the necessary materials biopatch, alcohol wipes, plastic wrap or aluminum foil, soap, and dressing kit and get started. Next, you will want to place the biopatch so the slit is either near or underneath the patients catheter. At home you will need to change the dressing that protects the catheter site. Picc or midline catheter sterile dressing change if parts of the gel come off the dressing, remove the gel with a sterile saline soaked gauze. Prise transparent wings off and remove the statlock. We recommend you check out their step by step picc line dressing guide with illustrations. Now most of the medical centers are placing a biopatch or algidex at the time of insertion, what would the best practice be. If you are interested in buying biopatch dressing for your hospital, pharmacy, or physicians office, wolf medical supply carries a wide variety of chg impregnated dressings and kits including tegaderm chg iv dressing, 1 guardiva chg dressing, 1 biopatch blue dressing, guardiva picc dressing kits, guardiva central line dressing change kits. The end of this catheter goes into a large vein near your heart. We still use the bio patch, but soon we are switching to the kits with an anti microbial gel instead.
Change the dressing once a week or anytime it gets wet, loose or dirty. Picc line protector arm cast cover for shower adult, waterproof tpu shower bandage and cast. A picc line or peripherally inserted central catheter is a thin tube used to administer fluids, antibiotics and drugs directly into a vein in your arm. Biopatch picc line dressing change medview systems. Fourteen days after lij picc placement, when line dressing was taken down to change the site was draining green and yellow. Caring for the picc at home is not hard, but it must remain absolutely sterile. Johnson dressing helps reduce local infections, catheterrelated bloodstream infections crbsi and skin colonization of microorganisms commonly associated with crbsi in patients. It has been our practice in home care to change the dressing 24 hours post insertion of a picc or any central line. The technology biopatch for venous or arterial catheter.
The biopatch could be billed with hcpcs code a6209, but it would depend on the carrier if it would be reimbursed. Picc dressing kits, guardiva central line dressing change kits. Central line dressing change a central line picc, port, hickman or other tunneled catheter dressing change is a sterile procedure. The results demonstrate a significant reduction of skin irritation incidence and support the use of cavilon nosting barrier film as part of the picc line dressing change. You would not bill a procedure code for the dressing change unless it is done under anesthesia. It includes biopatch protective disk with chg, large purple nitrile gloves, 5. I hope you are able to have a weekly change of stat lock, bio patch and dressing. Use biopatch disk as part of a piv bundle to help protect the insertion site. Always check the length of the picc catheter from where it exits your skin to its tip with each dressing change. Since a picc is placed in one of your arms and you need two hands to change the dressing, it is best to have someone help you with the dressing change. Caring for a picc line involves changing the bandage about once a week or if it gets wet or soiled, flushing the line as recommended by your physician, protecting the catheter site. Alcohol is known to degrade the materials forming the particular line i use, which is the bard power hickman. Central line dressing kit with biopatch product details. You need evidencebased products and protocols to minimize the risks of vascular access complications and help you achieve better patient outcomes.
Once the transparent dressing is removed, a second person places a sterile finger on the picc line. When the dressing was next changed, the site appeared normal and biopatch was put back on concern for infection in very immunocompromised patient. If theres sluggish flow and difficulty flushing, inform the picc line specialist or physician to assess. Medical action central line dressing kit with biopatch. Excellence every day portal a focus on central lines. When doing my dressing changes, i wipe the lumens and skin with betadine. Which intravenous catheters are biopatch dressings placed on. Every site presents the potential for infection, dislodgement, skin damage, and other complications. Hold the catheter at the exit site with the other gloved hand to keep it from being pulled out when removing the dressing. Picc line dressing change with sorbaview shield dressing and. In the process we tried a few other dressings and were in touch with a number of companies and dressing nurses, and the recomendation we received was to switch the type of dressings we use every 69 months, and not to go back to a type we were allergic to. Medical action central line dressing kit with biopatch is sterile and for single use only. Peripherally inserted central catheter dressing change. Dont take the patients bp or draw blood on the arm that has the picc line.
Dressing change medical billing and coding forum aapc. Picc line dressing changes difficulty general nursing. During the 3months postimplementation, 28 picc lines were placed, 3 were replaced, and 4% had documented skin irritation. This is a shortterm temporary tube that is used instead of a regular iv intravenous line.