PICC Line Dressing Change Procedure Guidelines in NCCC, Slides of Biology

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Indications and Procedure Guidelines

for PICC Line Dressing Changes in NCCC

March 2017

WILL BE PERFORMED BY

• The PICC team
  • Nurse Practitioner
  • PICC RN
  • Neonatal Fellow
  • Neonatologist

IMMEDIATE INDICATIONS FOR

DRESSING CHANGE

• Reinforced with tape

WHAT IF THERE IS BLOOD UNDER

THE DRESSING?

• Only change if non

occlusive or reinforced

• Change within 7 days if

hemostatic product

(Statseal) has been used

PICC TEAM RESPONSIBILITIES

• Verify with infant’s nurse regarding the timing for

the PICC dressing change

• Infant’s nurse is to be available at the bedside for

the procedure

• Identify the safety bubble range for the

procedure

• Trash and cleaning will need to be postponed by

environmental services until the procedure is

completed

• Any staff within 3 feet of the area will need to wear a

hat & mask

BEDSIDE RN RESPONSIBILITIES

DURING PROCEDURE

• Available to assist with dressing change
• Gather extra supplies if needed
• May need to hold extremity or pacifier in

place

• Notify PICC team member of break in sterile

technique

PICC TEAM MEMBER PREPARES

FOR PROCEDURE

Gather equipment including:

• PICC line dressing kit (if available)
  • Suture removal kit
  • Steri Strips
  • Tegaderm (adequate size)
  • Chloraprep or Betadine
  • Alcohol Wipes
• Disposable mask/hat
• 2 pairs of sterile gloves (double gloving) Current size glove for inner glove and one size larger glove for outside glove
• Securement device (if available)
• Sterile field
  • Blue Drapes

PERFORM HAND HYGIENE

PLACE EQUIPMENT ON STERILE FIELD

• Swabs (attach to

bedside)

• Suture removal kit
• Gauze 2x2’s (PRN)
• Steri Strips
• Tegaderm

PREPARING THE DRESSING FOR REMOVAL

1. Remove outer steri strips 2. Loosen the tegaderm dressing

Use alcohol to moisten if necessary Stretch the edges of the tegaderm for easier removal

Assistant should hold extremity and PICC after Tegaderm is loose while PICC team member washes hands and becomes sterile

DOUBLE GLOVE

INNER GLOVE: Place current size

gloves on hands using aseptic technique

OUTER GLOVE: Place larger size glove

over inner glove

REMOVE THE OLD DRESSING

Remove old steri strip & tegaderm dressing in the direction towards the insertion site

Stabilize catheter disc with non dominant hand

TRANSPARENT DRESSING

• Place steri strip over hub
• Place a transparent

dressing (Tegaderm) over

the insertion site and the

“hub” of the catheter

• If possible, make sure

there is a slight curve in

the catheter under the

dressing (decreases

tension)

• May need to move “hub”

of catheter for different

pressure point on

extremity. (Can use

forceps in suture removal

kit)

SECURING THE CATHETER

• Using chevron technique, place a steri strip (adhesive side up) under the extension tubing next to the “hub”, crossing over the “hub” and on top of the transparent dressing
• Do not place over insertion site
• Place 1-2 steri strips on top of chevron cross area