Vascular Access Devices and Dressing Adherence
The US Centers for Disease Control and Prevention (CDC) and The Infusion Nurses Society (INS) agree that vascular access device (VAD) dressing integrity is a critical factor for the prevention of hospital‐ acquired infection. [1,2] In fact, dressing disruption is a major risk factor for central line‐associated bloodstream infections (CLABSI) and other catheter‐related infections. Enhanced dressing adhesion promotes sterility and saves time, as fewer dressing changes are needed.
Gum Mastic Liquid Adhesive and Dressing Adhesion
At the Association for Vascular Access (AVA) meeting in September of 2018, data from several quality improvement initiatives designed to increase dressing adhesion was presented, view some of these initiatives below:
Methodist Hospitals, Gary, Indiana 
In a large community hospital, peripheral IV dressing integrity without reinforcement was at 55% with 15% of dressings being disrupted with insertion site exposure. Dressing kits were updated to include gum mastic liquid adhesive to enhance dressing adherence. During the first six months after this intervention, dressings were reported to be 95% fully intact with less than 2% of dressings being disrupted with insertion sites exposed. After standardization, there was a temporal decrease in blood stream infections for eight months. What’s more, there was no reported increase in medical adhesive related skin injuries.
The Hospital of Central Connecticut 
Caregivers in a 24‐bed medical/surgical intensive care unit in Hartford sought to enhance staff adherence to an evidence‐based bundle of care and standardization of techniques and products related to central line insertion and maintenance, as point prevalence audits indicated suboptimal rates of dressing changes. Caregivers received education, and insertion and maintenance kits were outfitted with Mastisol® Liquid Adhesive. Before these measures were taken, only 16% of dressings remained intact. Results indicate that after these steps, there were no reported adverse events and that average days of dressing adherence increased with 88% of dressings remaining intact.
UC Health Memorial Hospital 
A vascular access team in Colorado Springs identified that central venous catheter dressings were becoming loose and/or soiled, requiring a dressing change before the optimal seven days. Results indicated that after the team introduced gum mastic liquid adhesive, PRN dressing changes decreased by 31%, bloody dressings by 15%, and loose dressings by 16%, resulting in an annual cost savings of approximately $40,000.
These initiatives clearly indicate that the prevention of dressing disruption is pivotal in reducing the risk of infection and improve quality of dressings administered, all while reducing costs and improving patient satisfaction.
Minimizing infection risk is an essential part of optimizing “The Triple Aim” of the Affordable Care Act. Eloquest Healthcare is committed to providing solutions that can help you reduce the risk of conditions like a central line‐associated bloodstream infection (CLABSI) and post‐operative wound contamination.
- O’Grady NP, Alexander M, Burns LA, et al. Guidelines for the prevention of intravascular catheter‐related infections, 2011. https://cdc.gov/hicpac/pdf/guidelines/bsiguidelines 2011.pdf. Accessed January 8, 2019.
- Vascular Access Device Management. In: Infusion Therapy Standards of Practice. J Infus Nurs.2016; S68‐
- Timsit JF, Bouadma L, Ruckly S, et al. Dressing disruption is a major risk factor for catheter‐related infections. Crit Care Med. 2012;40:1707‐14.
- DeVries M, Sarbenoff J, Wickert M, Hayes LM, Mestrovich C. Post‐Implementation Monitoring Following Introduction of Gum Mastic Liquid Adhesive for Vascular Access Dressings. Poster presented at: The Association for Vascular Access Annual Scientific Meeting; September 15‐18, 2018; Columbus, OH.
- Aldi, R, Galvin K, Weintraub S, Hemingway N, Pagliaruli S. Quality Improvement Initiative Results in the Standardization Processes for Central Line‐Associated Bloodstream Infection Prevention and Increased Adherence to Best Practice. Handout presented at: The AACN Horizons Conference; October 8‐9, 2018; Manchester, NH.
- Jameson, L. A Vascular Access Team’s Journey to Reducing PRN Central Venous Catheter Dressing Changes By Adding to the Vascular Access Tool Box. Poster presented at: The Association for Vascular Access Annual Scientific Meeting; September 15‐18, 2018. Columbus,