Hello All
We have gone "live" with the Power Glide. We brought it in-house as a replacement for our existing midline catheter. We already have P&P for midline placement. Our old midlines were placed using MST, Max Barrier, required informed consent and a physician order, and had dwell times often of 6+ weeks (mis-use in my opinion, but can't control it). As we have been placing the new catheters we are questioning whether all the same steps are needed.
I am wondering how others are developing their P&P around this new concept of an extended dwell IV. What are you doing different from old midlines and why? Dressing change frequency? Biopatch? Extension tubing with positive pressure cap? Are you calling it a midline for staff education or an "extended dwell peripheral IV"?
For example, we are using sterile technque, but not max barrier becuase it is an enclosed system. We don't touch the wire or catheter so we use a probe cover, fenestrated draping, sterile supplies, and sterile gloves, hat, mask.
Any input is greatly appreciated!
Catheters are defined by tip location, not by length or any particular feature of a specific brand. So why would anything be different just because you changed brands. The phrase "extended dwell catheter" is a marketing term, not a definition for a catheter. The FDA has 2 categories under which catheter comes to market, less than 30 days dwell and more than 30 days dwell. Standards of Practice establishes how they are inserted and cared for. So there should be no changes at the present time until research establishes a different standard. 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
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Hello,
The PICC nurses are going to pilot the Powerglide midline catheters in our facility. I understood they
may dwell in the patient for up to 29 days. The dressing/loop/connections and the securement device
will be changed weekly and prn like a central line dressing. We are going to use Biopatch.
We have not used midlines before. It was PICC or peripheral. I think the PICC nurses will carefully assess
the patient's needs prior to insertion because midlines are not for vesicant therapy.
Sherry Cline Martin RN, CRNI
The title of your post called this a midline catheter. The label of these new products calls it a midline catheter. That is defined by tip location in either the basilic or cephalic vein in the upper arm level with the axilla, distal to the shoulder. The standard of practice has always stated that the smallest and shortest catheter should be placed. So I would ask why are you placing an 8 to 10 in. length of catheter in the veins of the forearm? It would seem that you are risking an excessive length of the peripheral vein just to use these new devices. Also, if not placed in a midline tip location, could this be considered off-label use? If think it could. We do not have any evidence to use for establishing a different standard of practice for these catheters at this point. Maybe there should be a different standard when we have the needed evidence. But I would never place these lines in the forearm due to the label as a midline. Just my opinion. 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
Martha, why in the forearm? I can't think of any reason to place in the forearm but there are so many reasons NOT to do this. Do you see a benefit I am not understanding?