A message from the Best Practice Implementation Committee
In our efforts to decrease central line associated bloodstream infections (BSI), Seton has added a BioPatch dressing to each insertion kit for use on all central lines (exception: neonates and those who are allergic). Following a recent observational study, we have determined that physicians are more than willing to use the Biopatch (thank you), but we have a disturbingly high rate of errant placement.
Please be advised that when the central line has been placed, you will need to leave out enough space for the BioPatch to fit around the catheter. That means that you should NOT bury the central line up to the hub at insertion – instead, leave out approximately 1-2 cm to allow the Biopatch to fit snugly around the catheter at the insertion site. If the suture wings are too close to the insertion site, the BioPatch doesn’t fit around the catheter and the patient doesn’t get the full protection of the chlorhexidine.
Please reference the photo (above left) of a correctly placed central line with a BioPatch.
Facts about the BioPatch include:
- It is an effective method of decreasing BSI and is listed as a IIB recommendation from the CDC.
- It is a sponge dressing containing freeze dried chlorhexidine.
- It is placed around the catheter in order to allow the transfer of the chlorhexidine to the skin 360 degrees around the insertion site.
- It is changed weekly and prn when saturated.
The largest research study about BioPatch was published by Timsit etal. Chlorhexidine-impregnated sponges and less-frequent dressing changes for prevention of catheter-related infections in critically ill adults: a randomized controlled trial. JAMA. 2009 Mar 25;301(12):1231-41.
The Best Practice Implementation Committee
Sam Roberts, MD
Chair, Best Practice Implementation Committee
Chad Dieterichs, MD
President-elect of the Seton Medical Staff