I was asked the question today should we use sterile gauze to remove PIV. Someone said they read literature saying that tape is contaminated to 72% bugs and the question is the stacked gauze placing our pts at risk?
Last summer, I published a literature review on PIV and Infection. We have an extremely small amount of knowledge about PIV infections from insertion or care. I did not find anything about removal and infection prevention. You do need a dry gauze to facilitate clotting instead of a wet alcohol pad. Does that gauze need to be sterile? Nobody knows. I did not find any evidence of infection occurring from the removal process though. That article is
1.Hadaway L. Short peripheral intravenous catheters and infection. Journal of Infusion Nursing. 2012;35(4):230-240.
You can find the entire evidence table I created for this manuscript on our website under the Resources section.
I forgot to add that you are correct about tape being contaminated 72% of the time. A study of rolls of tape found on nursing units was cultured revealing this high level of contamination. Lynn
Lynn, I have frequently thought about the tape that we use. We keep it in our pockets, then put it back in our cart at the end of the shift. Then, someone else uses it during their shift. A continuous cycle! What can we do to help keep down the contamination!
This level of contamination has only been found in one study. So it could or could not be the same levels in other hospitals. I would strongly recommend only using IV start kits for PIV insertion that already contains any tape that may be needed. Better yet, the catheter should be stablized with an engineered stablization device. We should aim to eliminate tape from these roles, in my opinion. Any label needed for the tubing, etc should be a labeled designed for a specific purpose and not taken from roles of tape. That would be my approach. Lynn
Last summer, I published a literature review on PIV and Infection. We have an extremely small amount of knowledge about PIV infections from insertion or care. I did not find anything about removal and infection prevention. You do need a dry gauze to facilitate clotting instead of a wet alcohol pad. Does that gauze need to be sterile? Nobody knows. I did not find any evidence of infection occurring from the removal process though. That article is
1. Hadaway L. Short peripheral intravenous catheters and infection. Journal of Infusion Nursing. 2012;35(4):230-240.
You can find the entire evidence table I created for this manuscript on our website under the Resources section.
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
Thank you Lynn! I cannot find it in the resourses tab.
Resources on my website, not this one. See my signature for URL.
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 forgot to add that you are correct about tape being contaminated 72% of the time. A study of rolls of tape found on nursing units was cultured revealing this high level of contamination. 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
Lynn, I have frequently thought about the tape that we use. We keep it in our pockets, then put it back in our cart at the end of the shift. Then, someone else uses it during their shift. A continuous cycle! What can we do to help keep down the contamination!
Bobbi Martin, RN
Archbold Medical Center
This level of contamination has only been found in one study. So it could or could not be the same levels in other hospitals. I would strongly recommend only using IV start kits for PIV insertion that already contains any tape that may be needed. Better yet, the catheter should be stablized with an engineered stablization device. We should aim to eliminate tape from these roles, in my opinion. Any label needed for the tubing, etc should be a labeled designed for a specific purpose and not taken from roles of tape. That would be my approach. 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