A question has been raised from nursing students about INS not approving chevron taping for peripheral IV therapy. Is this a change? Could you let me know what INS resource discusses this topic? Rationale, etc. Thanks!
Those nursing students are wrong. I know there is nothing in the 2011 edition of the Standards of Practice. There is a new position paper about assessment frequency for peripheral catheters but I don't remember anything about taping in that paper. They could be talking about the fact that the Standards do say that catheter stabilization should be accomplished with an engineered catheter stabilization device. A transparent membrane dressing is not considered to a stabilizaiton device. I do not remember any INS resource that presents different taping methods much less recommend against one method or another. Also, I would expect these students to provide to you the resource they are talking about. This would put the responsibility for evidence based practice on the students and create a learning experience for them. Lynn
I can remember our instructor not wanting to use the chevron UNDER the tegaderm because some nurses get in the habit of using the tape on their stethoscope and not the tape in the kit.We were taught to place the tegaderm THEN chevron and also a piece of tape transversely across the cath but so the entry point still could be seen.I noticed in the videos from one major mfg suggested it is an important part to stabilize their cath.The transverse tape I mean. In my experience the transverse tape is quite effective in our older population to keep the cath from widening the insertion point. I am wondering it this method “evolved” into an INS standard to give it credibility, lol.
Way back around 2000 there was an article in a nursing journal that discussed the "L" method of taping and explained that it is more stabile that the chevron. I did my own little study and did find a lot less movement using the "L" method. I never chevron now. With the "L" method, the tegederm goes down first covering the new insertion site. A narrow piece of tape about 1 1/2 to 2 inches is threaded sticky side up between skin and the catheter hub. One side is folded parallel to the catheter and taped onto the tegederm, the other side goes over the catheter hub and the fold on the other side of the tape (forming the base of an L) and secured to the skin or the tegederm. A second piece of tape goes across the hub and over the half of the first piece of tape forming the base of the L. Hope that explanation is clear. I teach this by taping pens to the table, one with a chevron method and one with the L method. There is no question which method stabilizes the catheter better.
When I have time I'll try to dig up that article, is was only one page with photos and it was a long time ago. More than likely someone here published that article, and hey if it's you - Thanks!
Those nursing students are wrong. I know there is nothing in the 2011 edition of the Standards of Practice. There is a new position paper about assessment frequency for peripheral catheters but I don't remember anything about taping in that paper. They could be talking about the fact that the Standards do say that catheter stabilization should be accomplished with an engineered catheter stabilization device. A transparent membrane dressing is not considered to a stabilizaiton device. I do not remember any INS resource that presents different taping methods much less recommend against one method or another. Also, I would expect these students to provide to you the resource they are talking about. This would put the responsibility for evidence based practice on the students and create a learning experience for them. 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 can remember our instructor not wanting to use the chevron UNDER the tegaderm because some nurses get in the habit of using the tape on their stethoscope and not the tape in the kit. We were taught to place the tegaderm THEN chevron and also a piece of tape transversely across the cath but so the entry point still could be seen. I noticed in the videos from one major mfg suggested it is an important part to stabilize their cath. The transverse tape I mean. In my experience the transverse tape is quite effective in our older population to keep the cath from widening the insertion point. I am wondering it this method “evolved” into an INS standard to give it credibility, lol.
Way back around 2000 there was an article in a nursing journal that discussed the "L" method of taping and explained that it is more stabile that the chevron. I did my own little study and did find a lot less movement using the "L" method. I never chevron now. With the "L" method, the tegederm goes down first covering the new insertion site. A narrow piece of tape about 1 1/2 to 2 inches is threaded sticky side up between skin and the catheter hub. One side is folded parallel to the catheter and taped onto the tegederm, the other side goes over the catheter hub and the fold on the other side of the tape (forming the base of an L) and secured to the skin or the tegederm. A second piece of tape goes across the hub and over the half of the first piece of tape forming the base of the L. Hope that explanation is clear. I teach this by taping pens to the table, one with a chevron method and one with the L method. There is no question which method stabilizes the catheter better.
When I have time I'll try to dig up that article, is was only one page with photos and it was a long time ago. More than likely someone here published that article, and hey if it's you - Thanks!