Central line-associated bloodstream infection (CLABSI) occurrence is arguably 100% preventable, yet central venous access device (CVAD) related infections have a 12-25% mortality rate in the ICU setting¹. One to 2 of every 8 patients who develop CLABSI don’t survive. In the webinar, 18 Months of Sticking to it: Dedicated team site care using gum mastic adhesive for vascular access dressing adherence, Elena Nelson Squires, BSN, RN, OCN, VA-BC discusses whether gum mastic adhesive promotes better CVAD dressing adherence and decreased CLABSI risk. Dressing adherence during the COVID-19 pandemic was also assessed.²

Use of Gum Mastic Medical Adhesive to Maintain Central Venous Access Device Dressing Integrity, Banner Health, Northern Colorado facilities³

A study with a Northern Colorado Vascular Access Team (VAT) took place to determine if gum mastic adhesive promoted better CVAD dressing adherence and decreased CLABSI risk. Site care with the gum mastic adhesive was performed every 7 days on 33 patients while 20 other patients received standard CVAD site care as a control. Seven of 20 control patients (35%) had early dressing disruption compared to 0 disruptions in the 33 patients (0%) with gum mastic adhesive. No patients in either group developed CLABSI.

Through cost analysis, an extra CVAD dressing kit for the 7 early dressing disruptions costs double the gum mastic adhesive for all 20 control patients ($63 versus $27). A CVAD dressing change requires at least 15 minutes at a nurse labor cost of $13.82. Seven extra CVAD dressing changes cost $96.75 in labor compared to $18.40 for gum mastic adhesive. Application of gum mastic adhesive only requires an extra minute for each CVAD dressing change, costing $0.92.

Vascular Access Dressing Integrity Within the Current Health Crisis

Nelson Squires explained how site care from the VAT changed amidst the COVID-19 pandemic. The VAT were instructed to not enter certain patient rooms for site care in order to preserve PPE resources at facilities.

Instead, Critical Care Nurses were changing patients’ dressing instead of calling the VAT. Nelson Squires performed an audit at North Colorado Medical Center on May 4^th 2020 of 86 dressings that were placed; 43 with gum mastic adhesive by VAT and 43 without gum mastic adhesive by bedside RN/providers. Partial disruption of only 4 dressings placed by VAT specialists occurred while 23 of the dressings placed by bedside RN/providers needed early dressing changes due to disruption.

Nelson Squires believes dressing integrity decreased due to confusion and fear building from the pandemic and also lack of resources at that time. Within this audit, nursing time, cost, and supply expense was lower when gum mastic adhesive used.²

To prevent dressing disturbance and CLABSI, Nelson Squires emphasized the importance of daily rounds incorporating the specifics of site care. VAT specialists should uphold site integrity by monitoring dressing adherence, the presence of disinfection caps, current date labels, and explicitly following policy guidelines and formal audits despite the current health crisis. Gum mastic adhesive should be put on every dressing, every single time for improved VAD dressing integrity.¹

For more information about Mastisol^® Liquid Adhesive, Detachol^® Adhesive Remover, or information on Vascular Access Dressing Adherence Point Prevalence Assessments, please contact your sales consultant or Eloquest Healthcare^®, Inc., call 1-877-433-7626 or visit www.eloquesthealthcare.com.

References

1. Raad, I., Hend, H., and Maki, D. (2007). Intravascular catheter-related infections: advances in diagnosis, prevention, and management. The Lancet: Infectious Diseases, 7(10), p. 645-657.
2. Nelson Squires, E. (July, 2020) 18 Months of Sticking to it: Dedicated team site care using gum mastic adhesive for vascular access dressing adherence [webinar].
3. Nelson Squires E, Bruggeman S. Use of Gum Mastic Medical Adhesive to Maintain Central Venous Access Device Dressing Integrity. Poster presented at: 2019 Association for Vascular Access Meeting; October 2019; Las Vegas, NV.