• myGriffith
    • Staff portal
    • Contact Us⌄
      • Future student enquiries 1800 677 728
      • Current student enquiries 1800 154 055
      • International enquiries +61 7 3735 6425
      • General enquiries 07 3735 7111
      • Online enquiries
      • Staff phonebook
    View Item 
    •   Home
    • Griffith Research Online
    • Conference outputs
    • View Item
    • Home
    • Griffith Research Online
    • Conference outputs
    • View Item
    JavaScript is disabled for your browser. Some features of this site may not work without it.

    Browse

  • All of Griffith Research Online
    • Communities & Collections
    • Authors
    • By Issue Date
    • Titles
  • This Collection
    • Authors
    • By Issue Date
    • Titles
  • Statistics

  • Most Popular Items
  • Statistics by Country
  • Most Popular Authors
  • Support

  • Contact us
  • FAQs
  • Admin login

  • Login
  • Comparing the Effectiveness of Four Dressing and Securement Methods for Peripherally Inserted Central Catheters: A pilot randomized controlled trial

    Author(s)
    Chan, Raymond
    Northfield, Sarah
    Larsen, Emily
    Mihala, Gabor
    Ullman, Amanda
    Rickard, Claire
    Griffith University Author(s)
    Mihala, Gabor
    Rickard, Claire
    Chan, Ray
    Year published
    2018
    Metadata
    Show full item record
    Abstract
    Background: Peripherally inserted central catheters (PICCs) are commonly used for delivering systemic anti-neoplastic therapy. PICC failure is unacceptably high (up to 40%) due to mechanical, infectious and thrombotic complications. Poor securement potentiates all complication types. This randomized controlled trial (RCT) aimed to examine the feasibility of a large RCT of four dressing and securement methods to prevent PICC failure. Methods: This single-centre pilot RCT included 124 admitted medical/surgical/cancer patients aged ≥ 16 years with a PICC. Interventions were: (i) standard polyurethane dressing and sutureless ...
    View more >
    Background: Peripherally inserted central catheters (PICCs) are commonly used for delivering systemic anti-neoplastic therapy. PICC failure is unacceptably high (up to 40%) due to mechanical, infectious and thrombotic complications. Poor securement potentiates all complication types. This randomized controlled trial (RCT) aimed to examine the feasibility of a large RCT of four dressing and securement methods to prevent PICC failure. Methods: This single-centre pilot RCT included 124 admitted medical/surgical/cancer patients aged ≥ 16 years with a PICC. Interventions were: (i) standard polyurethane dressing and sutureless securement device (SPU + SSD, control); (ii) polyurethane with absorbent lattice pad dressing (PAL + Tape); (iii) combination securement-dressing (CSD); and (iv) tissue adhesive (TA + SPU). All groups except TA + SPU had a chlorhexidine-gluconate (CHG) impregnated disc. Feasibility outcomes were recruitment and safety/acceptability of the interventions. The primary outcome was PICC failure, a composite of PICC removal for local infection, catheter-associated bloodstream infection, dislodgement, occlusion, and/or catheter fracture. Secondary outcomes included individual complications, dressing failure and dwell time, PICC dwell time, skin complications/phlebitis indicators, product costs, and patient and staff satisfaction. Results: PICC failure incidence was: PAL + CHG + Tape (1/5; 20%; 17.4/1000 days), SPU + SSD + CHG (control) (4/39; 10%; 9.0/1000 days), TA + SPU (3/35; 9%; 9.6/1000 days), and CSD + CHG (3/42; 7%; 9.4/1000 days). Recruitment to PAL + CHG + Tape was ceased after five participants due to concerns of PICC dislodgement when removing the dressing. CSD + CHG, TA + SPU (TA applied only at PICC insertion time), and control treatments were acceptable to patients and health professionals. PICC failure was approximately 90% less likely in women than in men (HR=0.10, 95%CI=0.01–0.87, p=0.037), but increased fourfold in patients with ≥3 comorbidities, compared to those with one or no comorbidities (HR=4.62, 95%CI=1.04–20.4, p<0.005). Discussion: A large RCT of CSD + CHG and TA + SPU (but not PAL + CHG + Tape) versus standard care is feasible. Male gender may increase the risk of PICC failure due to men being more hirsute, which can disrupt dressing adhesiveness and having more muscle movement. Clinicians should work to ensure best insertion, monitoring and maintenance practice in men, and those with ≥3 comorbidities.
    View less >
    Conference Title
    Oncology Nursing Forum
    Volume
    45
    Issue
    2
    Publisher URI
    https://ons.confex.com/ons/2018/meetingapp.cgi/Paper/2870
    Subject
    Nursing
    Science & Technology
    Life Sciences & Biomedicine
    Oncology
    Publication URI
    http://hdl.handle.net/10072/403245
    Collection
    • Conference outputs

    Footer

    Disclaimer

    • Privacy policy
    • Copyright matters
    • CRICOS Provider - 00233E

    Tagline

    • Gold Coast
    • Logan
    • Brisbane - Queensland, Australia
    First Peoples of Australia
    • Aboriginal
    • Torres Strait Islander