Good Morning,
We are trialing a new midline catheter. What is the concensus about utilization of maximal sterile barriers for the insertion of midlines. INS Standards cite max barriers for CVADs but are not specific to midlines. Thoughts ? References ?
Thank you, Dave B
INS SOP is not specific for midlines because there was no evidence either way for MSB during insertion. Lynn
Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
I was just going to post this question myself.
I reviewed the INS standards; of course Lynn mentioned already about that. But....since the standards say clean gloves and no touch for short and midline catheters I would have to say at this point that is acceptable practice. Is there not enough studies done on midlines, or just the studies dont justify a specific practice.
I have heard many say they utilize full maximal barrier precautions though?? We are keeping this line in someone for many more days than a peripheral so there is some concern about that. Especially when we find significant biofilm growth after 5 days of a line being in place. So......skin cleansing would be key.
However, the INS standard says no touch ; so if you are using an ultrsound to access site for midline we would be touching the site, right?? so maybe a sterile probe cover to be used?? of course then...need sterile jelly too?? then it seems like we would just talk ourself into doing it full maximal barriers. We are used to that anyway.
I have never been a fan of midlines. (maybe due to lack of knowledge) I have never ussed them but had much concern about a line that you couldnt use vessicants in, and the potential for mis use. then, I attended the recent conference from AVA in Orlando and they made be re think that.
I know I have many patients who really dont need a central line, but they are unable to access them any other way so I put a PICC line in. I am now realizing I have many patients who could benefit from this type of access (midline).
I saw the Power Wand at the conference, and then in the most recent journal I saw the Power Glide by Bard. The Bard products appears to be much more user friendly and after watching the video feel like that would be very simple. Has anyone tried it yet?
anxious to hear your feedback, thanks, Gina Ward R.N.
Gina Ward R.N., VA-BC