Importance of Vascular Access Device (VAD) Securement
Following VAD insertion, it is important to take measures to secure the device to the skin to decrease dislodgement risk and prevent catheter movement. Doing so also contributes to VAD longevity and functionality throughout the duration of treatment. The methods used to secure VADs, including peripherally inserted central catheters (PICC) and centrally inserted central catheters (CICC) should not interfere with the ability to routinely assess and monitor the access site, nor impede delivery of prescribed therapy.1
Increasing performance and success of VADs is imperative when considering the prevalent rates of catheter failure, malposition, infection, and dislodgement complications.2 Accidental VAD dislodgment is reported to occur 1.8%-24% of the time, and the consequences of these complications can be significant. Poor securement can negatively impact the course of treatment and lead to infection. This can result in prolonged hospital stays, during which additional interventions and/or VAD replacement may be needed. 3
Selecting the Appropriate Type of Securement
The 2021 Infusion Therapy Standards of Practice recommend choosing the most appropriate method of VAD securement based on a variety of patient-related factors. These include patient age, skin turgor and integrity, anticipated therapy duration, previous adhesive skin injury, the presence/type of any drainage from the insertion site, and VAD type.1
When evaluating the right securement option for your facility, aim for:
Effectiveness of Different Securement Methods
While use of sutures or adhesives remains prevalent practice in the context of VAD securement, these securement methods present significant complications. Sutures are designed and indicated for wound closure; they are not meant to be used for device securement. Improper suture use leads to compromised dressings and displaced catheters due to the tension and weight of patients’ lumens, hair, skin folds, and moisture. Adhesive securement methods may also be challenged by many of these same variables and risk VAD dislodgement and migration risk with each dressing change.
Subcutaneous Anchor Securement Systems (SASS) offer a single-application solution that stabilizes the catheter beneath the insertion site, lasting the duration of dwell time. This can provide a sense of confidence, ease, and success for clinicians during care and management of patients’ VAD. SASS aligns with considerations regarding elevated patient outcomes, improved quality of care, and reduced total costs of such care.
Vascular Access Device Site Assessment
Eloquest Healthcare, Inc. can partner with your institution to facilitate a Vascular Access Device Site Assessment to determine the state of vascular access device & dressing securement for patients in your facility, while providing you and your team with information on your facility’s infection risk, nurse efficiency, and potential product waste. Click HERE to request a Vascular Access Device Site Assessment today!
References
- Gorski, et al., Infusion Therapy Standards of Practice, 8th Edition, J. Infus Nurs. 2021 Jan-Feb
01;44(1S Suppl 1):S1-S224. - Hill S, Moreau N. Right Securement, Dressing, and Management. Vessel Health and
Preservation: The Right Approach for Vascular Access. 2019. Available at:
********link.springer.com/chapter/10.1007/978-3-030-03149-7_9. - Moureau N, Poole S, Murdock M, Gray S, Semba C. Central venous catheters in home infusion
care: outcomes analysis in 50,470 patients. J Vasc Interv Radiol. 2002;13:1009–16.