I have been asked to come up with a reason to NOT go to same-day-of-the-week central line dressing changes. We change at 24 hr post-isertion only if there is blood on the Biopatch present. We then go to weekly changes based on whatever day of the week it is. Our management wants all dressings done on the same day & I have to justify why we don't want that.
Anyone have input? INS doesn't have anything I can find addressing this issue.
Rene Maslow, RN, CRNI
Kaiser Santa Rosa PICC/Procedure RN
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I would be curios as to the rationale. A line that gets put in on a monday, certainly doesn't need to be changed on weds. Also, it would be opening up the sterile site more than necessary potentiating the risk for infection. Line manipulation and dressing changes = open sterile site = more risk for infection. The only thing I can think of is if there is an issue with dressing not getting changed on time (missed or no time ect.) A "dressing change day" may help for something like that as there is a bigger risk of infection with messy, overdue dressings than early dressing changes. The other thing you could mention is the increased cost for dressing supplies. CVC kit + Biopatch + Stat Lock = about 10-15$ per dressing times however many early dressings.
I would be curios as to the rationale. A line that gets put in on a monday, certainly doesn't need to be changed on weds. Also, it would be opening up the sterile site more than necessary potentiating the risk for infection. Line manipulation and dressing changes = open sterile site = more risk for infection. The only thing I can think of is if there is an issue with dressing not getting changed on time (missed or no time ect.) A "dressing change day" may help for something like that as there is a bigger risk of infection with messy, overdue dressings than early dressing changes. The other thing you could mention is the increased cost for dressing supplies. CVC kit + Biopatch + Stat Lock = about 10-15$ per dressing times however many early dressings.
First I would want to know what problem is this approach trying to solve. Then I would have to evaluate this reason for changing. I can easily see times when a line was placed on Mon or Tues and the dressing change day is Wed. The thoughts of many nurses would be that it is only 1-2 days old so we will just leave it for another week, going to 8 or 9 days. What amount of your dressings are not adherent for a full 7 days? I would want to know this number to make a complete decision. Dressing change weekly is fine as long as it remains clean, dry, and totally adherent. How good is your staff at immediately changing it when it becomes wet, dirty or non-adherent? 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