Our Vascular Access Nursing team has worked with Powerglide over the last year and a half. We were excited to have another option in our tool kit for our patients and reduce the use of CVCs. We are a team of 13 nurses who service two community hospitals for PICC, midline, PIV, USGPIV and much more. I have greater than 25 years of experience in Infusion Nursing. I felt it important to share some of what we have learned
Catheter securement is not well designed or effective
Crimp memory is a problem especially in the obese patients
Guidewire is very nice and we have a preference for nitinol
The manufacturer has responded quickly to our suggestionsin for kit and catheter design changes
It takes 10 not 3 supervised procedures to be really good at this
We never used them in the forearm
Sure looks acts and feels like a PIV catheter that was made longer. Not really designed for the longer dwell claimed and we did see few that actually made it to 28 days
There is no other procedure performed at the bedside by nurses that requires three things be in the vascular compartment all at the same time, one being a needle
There have been multiple episodes of jamming of the device during advancement requiring removal.
If it can happen it will
I have a talented set of nurses with lots of experience in vascular access. Devices fail. Inserters make errors. It doesn't matter who or what you point the finger at no one intends for bad things to happen. It did happen and not just to us. Catheter shearing and guidwire shearing have been reported on the FDA website as adverse events. Ask yourself again, "Do I have to have three things in the vessel at once doing anything else?" Another question I asked myself was, "three different US procedures in the same morning, all with different techniques and different configurations, room for user error?" Yes there is. I have decided to move away from the Powerglide and begin looking at midlines that have an insertion technique much like the PICC insertion. I have to restore the self confidence of my inserter who continues to beat herself up becasue there is doubt in her about whether it was her or the device. If I eliminate a little risk all will benefit. I challenge the manufacturers of both Powerglide and Power Wand to make this procedure different and better. Until then I am not interested.
I have to ask, are you a needle guide team or a free hand team?
It does seem to go easier for freehanders. No problems at all here. I love them.
We have always been "free handlers"
Jose Delp RN BSN VA-BC
Also had a 'shearing' event during the trial with PowerGlide. Catheter ended up in the mid left pulmonary artery. Needless to say, trial over.
That should get reported by your risk management team on the FDA website. The vendor must address their part on this as well. We have done this. I suspect there is a lot more of this than reported becasue the company goes in and re-educates. REALLY need to change that design!
Jose Delp RN BSN VA-BC