Dressing Decisions
This dressing is the option for most patients who are safe for CHG use and have a PICC.
What is a Tegaderm CHG dressing?
You are changing IV tubing connected directly to another line segment. There is no needleless connector between the two tubing pieces. Before connecting the new tubing, what must be done?
What is scrub the line-to-line junction with a Prevantics pad before reconnection?
Clue: When cleaning a central line insertion site, antiseptic should always move in this direction.
Answer: What is from the insertion site outward?
A dressing should be labeled with what info?
What are the bedside RN initials and date?
During a PICC dressing change, a nurse notices the external visible length (EVL) is 2 cm longer than the last documented measurement and attempts to push the catheter back in.
What is improper management of a PICC migration? If the EVL is greater than previously documented, do not attempt to reinsert the catheter. Document the new EVL and notify the provider/VAT
This product should only be used when a patient has a confirmed CHG allergy.
What is Algidex?
A nurse disconnects tubing from a line-to-line connection and immediately reconnects new tubing without disinfection because there is no cap present to scrub.
What is a break in line entry practice? All connection points must be disinfected prior to re-entry, even when a needleless connector is not present.
Clue: Betadine must dry for at least this long before removal.
What is 2 minutes minimum?
This healthcare worker's role during a dressing change is to observe for sterility and coach the procedure.
Who is the second RN?
While performing cap entry, the nurse scrubs the hub appropriately but immediately accesses it before it has dried.
What is failure to allow adequate dry time after disinfection? The Prevantics scrub must dry completely for at least 5 seconds before access.
For a double-lumen port requiring a dressing, these special pieces help secure the lumens.
What are dressing "pants" and a top piece?
What should be used to maintain the sterility of the new set up (fluid line on a tri-piece) when changing tubing?
A red cap. The red caps should be used to maintain sterility of extension pieces and lines.
The embedded CHG gel pad should cover this structure.
What is the catheter insertion site?
How should Mastisol and detachol be used on CHG inbedded dressings?
Mastisol around the edges when applying the dressing and Detachol around the edges when removing the dressing.
While assessing your patient's dressing site, you notice the phalange is sticking out of the window of the dressing, What do you do?
What is Change the dressing? Any part of the line outside the window results in a unocclusive dressing.