Dressing and Securement

Prof Claire Rickard
RN, BN, Grad Dip (Crit Care), PhD, FACN
AVATAR Founder
Director, Dressing and Securement
Email: c.rickard@griffith.edu.au

Ineffective dressing and securements are a major risk factor for IV device failure. Wet or bloodied dressings risk serious infection developing. Loose dressings or poor securement to the skin mean devices fall out, or enter the tissue rather than the vein or artery. Even when devices remain in place, ongoing small movements from poor securement lead to irritated and painful veins/arteries with swelling, clot formation and complete blockage.

Despite a multitude of dressing and securement products, we lack high-quality evidence to say which is best. Healthcare organisations struggle to know which to use. In one study, 7 different types of dressing and securement were used in the same hospital, and 25% did not meet the basic criteria of being clean, dry, and intact. When better products appear, they may not be used due to a higher purchase price, if  research has not been published to show that they save money overall by reducing complications.

There is no 'one-size-fits-all' solution. Dressing and securement needs differ by insertion site (e.g. groin vs. scalp); uses (e.g. intermittent injection vs. multiple heavy infusion lines); and patient groups (e.g. babies with little space to secure neck devices, and older people with frail skin vulnerable to tearing).

The good news is that risk can be reduced by better products and best practice use. Patients and families can also help to prevent problems. It can be as simple as prompting the nurse or doctor that the dressing is loose or wet and needs to be replaced.

AVATAR has a strong focus on the cost-effectiveness of both current, and new, dressing and securement options. In partnership with patients, leading hospitals, clinical experts and commercial providers, we test products in careful, large-scale randomised controlled trials, across many patient groups and types of device. Our vision is to end suffering and waste from vascular access device failure.

   

 

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