We're adding TSM dressings to our CVC policy-which was exlusively gauze-tape.   I need help defining the situations that would call for a dressing to be changed before it's due.  Obviously when the dressing is torn, or if the rim is breached by bleeding/drainage from underneath, or when an edge has loosened enough to allow the site to be exposed to air. But how about when the taped rim becomes wet after a shower, or when a small area of the taped edge isn't sticking--can it be resecured or is it best to change?   Now that nurses can see the site, they feel they need to change the dressing because they can see a small amount of blood at the entry site or around the sutures (our PICCs are still being sutured).   Also, we're using 3M Tegaderm, does anyone recommend another product?

we like the sorbaview...very

we like the sorbaview...very adherent yet does not cause skin excoriation...99% of the time it is still secure after a week

The national standard is to

The national standard is to change the dressing when it becomes wet, dirty, or non-adherent. If there is blood under the dressing, I would change it. If the edge is loose, I would change it. I do not ever place tape around the edges of a transparent dressing because I have never found it to be necessary. If you use a skin protectant solution such as SkinPrep or NoSting Barrier, adherence to the skin is never an issue. And I would always use one of these solutions from the very first day because I think they go a long way in preserving the integrity of the skin under the dressing. If the dressing is wet from a bath or shower, I would change it. When in doubt, change it! 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