This question has been asked before but I would like updated responses. We are being asked to look at switching from Stat-Locks for securing PICCs to the Sorbaview Shield, which is marketed as having a "built-in" stabilization device and of course, would be less expensive. While we will sometimes have a dressing "lift" from moisture, perspiration, etc, before the 7 day change, rarely does the Stat-Lock become dislodged. We are reluctant to trust the PICC securement to a dressing only. The previous comments on usage of the Shield were mixed. I was wondering what the most recent experiences have been? Ours is a peds population only, so reliable securement is vital.
Holly Hess, Ped Vasc Access
Wolfson Children's Hospital
Jacksonville, FL
I have never seen any published data on Sorbaview Shield alone or in comparison to any other stablization product. So looks like all you have got to rely on is the anecdotal experience of others. Let us know what you decide. Lynn
Lynn Hadaway, M.Ed., RN, BC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
I actually put a SorbsView Shield on my self with a PICC line taped to my arm to see if it would withstand pulling and not move as well as to see if the product was irritating to the skin. I had ,it on for 5 days and usually have serious reactions to adhesive. I tugged multiple times and it did not move. I had absolutely no skin irritation so I started using it about 2 years ago. I don't have any neos or even peds patients but it does work very well on the adult population. I must warn though, you need to secure the PICC line below the dressing with a piece of tape before removing it and use caution removing the dressing at the insertion site because I did have one PICC move out 2 cm because I did not see that the dressing was stuck to the PICC at the insertion site. Now I use a sterile alcohol wipe to remove the dressing from the PICC itself by wiping toward the insertion site. Valorie
Valorie Dunn,BSN, RN, CRNI, PLNC
We switched from Stat Lock to Sorbaview Shield over a year ago, and our dislodgement rates went down. The Stat locks were so cumbersome, that the catheters were getting dislodged during dressing changes. It has been a huge patient and staff satisfier at this childrens hospital. We have not had any reported reactions to the dressings either.
Thanks
Tammy
May I kindly suggest you look at the I.V. Advanced Securement Line of dressings. There are I believe 3 sizes and one of them may very well work for your peds.
Securement of the IV advanced securement dressings is equal to a stat lock without the skin damage one often sees upon removal of a stat lock. After all, how skin friendly can a stat lock device be if it requires alcohol to remove it?
Frankly I find Sorbaview dressings are just an well marketed product that do not live up to real tests, Published Clinical Studies. Finding published clinical studies on a Sorbaview Shield dressings prove virtually impossible while there are hundreds of them out there on tegaderm dressings in a wide variety of journals.
As you saw Holly, securement results were questionable and besides why would you want to hold moisture next to the skin in that thing they call an absorbent ring?
LIP
We switched to Tegaderm I.V. Advanced Securement dressing about a year ago and have had good results. We initially had a few PICC lines that displaced about 2 cm but had further education from 3M clinical nurse trainer and realized we weren't using the tape they provide appropriately. Since then the PICC lines have been remaining in place with the new Tegaderm minus the Statlock.
Carole Rumsey, RN, CRNI
Home Infusion Program Manager
Sutter Infusion and Pharmacy Services
Sutter Care at Home
Northern CA
[email protected]
This is an interesting discussion. We have also looked at Sorbaview Shield as an alternative to Statlock (solely for the cost savings and ease of application), but have not been convinced enough to take the leap. We have used Statlock in our pediatric institution both for perihperal IVs and PICCs for years with great success. Application of Statlock in both instances can be cumbersome until you get the hang of it, but for us, the benefits have far outweighed the difficulties. It would be great if anyone who has made the switch would publish their results.
To briefly respond to "LIP" - we have not had any issues with skin integrity with the Statlock, including in our neonatal and micropremie populations. Have you actually seen breakdown occur or are you speculating that it is possible (based on your comment about what you would expect with an adhesive that must be removed with alcohol)? As one charged with maintaining vascular access devices, I appreciate a product that does not release its adhesive when exposed to sweat, oils, or other moisture.
Morgan,
For your information, yes there are reports and visualization of skin breakdown and no it is not just speculation. May I kindly suggest you speak to a skin care team member at your hospital. Skin damage caused by improper removal of tape, securement devices, dressings falls right behind improper positioning and beds as one of the top causes.
The product clearly says "removal with alcohol" which indicates that it uses a very agressive adhesive and would not work well on anyone with fragile, elderly or at risk skin. RN's report all the time that removal or stat locks causes skin damage including skin tears. Why would you even consider using it on a neonate whose skin is still developing?
Then there is the fact that many nurses will not bother using them even when made available, a huge waste of money. Compliance Utilization of stat lock is an issue.
We all know that oils, cremes, sweat can compromise adhesives. Hopefully everyone knows to apply any adhesive only to dry skin (or dry the skin) which will make anything with an adhesive stick better but some times people are rushed and do not dry the skin or let a prep dry for instance.
Stat locks on PIV's are overkill and cost way too much when there are alternatives that work with less potential for skin damage and much less cost.
Logan Puckett