Vascular access devices: securement and dressings

Abstract

Many patients admitted to hospital will require a vascular access device (VAD). Insertion of VADs is often viewed as a routine procedure, with little attention given to the importance of appropriate securement and dressing and how these factors can affect patient outcomes. This article discusses the types of VAD available and the rationale for VAD securement and appropriate dressings to minimise complications.

Peripheral Venous Catheter-Related Adverse Events: Evaluation from a Multicentre Epidemiological Study in France (the CATHEVAL Project)

“…The release of thromboplastic substances and platelets promotes blood clotting and may cause the constriction and occlusion of the catheterized vein. This may result in the leakage of intravenous fluids from the insertion site, or their infiltration into the surrounding tissues, and subsequently impairment of venous access, as reported in our study and described in others [1,7]. The second was the soiled/unclean dressing observed during the indwell time.…”

“…The second was the soiled/unclean dressing observed during the indwell time. This situation could provide an ideal opportunity for increasing infection-producing microorganisms [1,7], especially when non-transparent dressings are used, increasing the risk of not detecting infection. In France as in other countries, guidelines recommend the use of transparent, semi-permeable polyurethane dressings [2].…”

“…It was considered as a fully-fledged PVCAE when it was observed in the absence of any other signs. Phlebitis, which is the irritation and inflammation of a vein wall caused by the presence of the PVC [1,7], was assessed based on Ray Maddox phlebitis grading scale [17] with minor modifications (see Table 1). The scale graded phlebitis according to five levels of severity based on the presence or absence of the following symptoms: pain at venepuncture site, erythema, swelling, induration, palpable venous cord, pus at the insertion site.…”

“…Peripheral venous catheters (PVC) are the most frequently used medical devices during hospital cares [1]. In France, up to 25 million of PVCs are placed every year [2] and nearly 20% of hospitalized patients carry such a device [3].…”

Evaluation of the Use of a Stabilization Device to Improve the Quality of Care in Patients With Peripherally Inserted Central Catheters

“…In addition, their immature skin integrity and immune system predispose them to infection. 8 National guidelines have been published that recognize catheter stabilization as a key intervention to assist in the decrease of phlebitis, catheter migration, and dislodgement, and are potentially helpful to decrease the risk of CLABSIs for all populations. 6 Many hospitals have implemented the use of a stabilization device, such as the StatLock device (Bard Access Systems, Inc, Salt Lake City, Utah), to assist in preventing complications such as dislodgement.…”