- ABOUT STATLOCK® TAPE-FREE STABILIZATION DEVICES
ABOUT STATLOCK® TAPE-FREE STABILIZATION DEVICES
IV PRODUCTS:
1. Is the StatLock® Stabilization Device IV appropriate for all patients with PIVs?
Nearly. The StatLock® Stabilization Device is contraindicated in patients with known adhesive or tape allergies. While the StatLock® Stabilization Device is probably appropriate for more than 99% of your patients; some people have skin that simply will not accept an adhesive-based product – their skin is too flaky, too greasy, or too diaphoretic. You need to use your clinical judgment. Just know that where you can use StatLock® Stabilization Device, your clinical and cost outcomes will be dramatically improved.
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2. Do I have to use a special skin prep for StatLock® Stabilization Device IV products?
You do need to extend your insertion site alcohol prep or chlorhexidine prep widely to both sides to cover the securement site. This is a necessary step to cleanse the skin before the StatLock® Stabilization Device application. C.R. Bard always recommends the use of the skin prep pad included with StatLock® Stabilization Device. The skin prep provides an acrylic layer that protects the skin and enhances adherence of the anchor pad. Performing both of these steps will maximize product performance. When you use the skin prep you’ll need to allow it to dry for 10 to 15 seconds and make certain it is dry, meaning smooth to the touch – not tacky. Use your clinical judgment based on assessment of the patient’s skin. Just remember, when skin prep is not used the StatLock® Stabilization Devices may prematurely lift.
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3. Any special tips or instructions for actually snap fitting the StatLock® Stabilization Device IV Ultra onto the catheter?
Yes:
4. What do I use the sterile StatLock® Stabilization Device adhesive foam strips for?
You can use them to:
5. What if I need to change the IV tubing, do I have to remove the StatLock® Stabilization Device first?
If you had a tape-secured PIV, then you surely would have to remove the tape to change the tubing.
With the StatLock® IV Ultra Stabilization Device you can keep the securement device in place while you change tubing. Simply steady the retainer with the thumb and index finger of one hand while unscrewing the extension set. Remove the set. Then, while continuing to brace the retainer, press-fit and screw in your replacement extension set. For StatLock® IV Select Stabilization Device, you will need to replace the StatLock® Stabilization Devices when you remove and replace the tubing – just as you would with tape securement; but this is a rare event offset by StatLock® Stabilization Device advantages.
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Nearly. The StatLock® Stabilization Device is contraindicated in patients with known adhesive or tape allergies. While the StatLock® Stabilization Device is probably appropriate for more than 99% of your patients; some people have skin that simply will not accept an adhesive-based product – their skin is too flaky, too greasy, or too diaphoretic. You need to use your clinical judgment. Just know that where you can use StatLock® Stabilization Device, your clinical and cost outcomes will be dramatically improved.
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2. Do I have to use a special skin prep for StatLock® Stabilization Device IV products?
You do need to extend your insertion site alcohol prep or chlorhexidine prep widely to both sides to cover the securement site. This is a necessary step to cleanse the skin before the StatLock® Stabilization Device application. C.R. Bard always recommends the use of the skin prep pad included with StatLock® Stabilization Device. The skin prep provides an acrylic layer that protects the skin and enhances adherence of the anchor pad. Performing both of these steps will maximize product performance. When you use the skin prep you’ll need to allow it to dry for 10 to 15 seconds and make certain it is dry, meaning smooth to the touch – not tacky. Use your clinical judgment based on assessment of the patient’s skin. Just remember, when skin prep is not used the StatLock® Stabilization Devices may prematurely lift.
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3. Any special tips or instructions for actually snap fitting the StatLock® Stabilization Device IV Ultra onto the catheter?
Yes:
- Always orient the push-tab straight up.
- Always connect the StatLock® Stabilization Device to the PIV BEFORE placing the StatLock® Stabilization Device onto skin.
- The blue StatLock® Stabilization Device retainer clip is like an upside-down “V”. Therefore, do not inadvertently squeeze it closed by compressing both sides. Instead, just hold one side and snap it over the hub of the catheter.
4. What do I use the sterile StatLock® Stabilization Device adhesive foam strips for?
You can use them to:
- Stabilize the catheter while prepping and securing with the StatLock® Stabilization Device by applying the foam strips over the catheter hub
- Fashion a J-loop with the IV tubing
- Form a cushion under your luer lock spin nut
- For extension sets without luer locks, wrap them around the catheter and the extension set connection for added security
- Reinforce the StatLock® Stabilization Device … or, whatever you like; the point is they are sterile, tape is not
5. What if I need to change the IV tubing, do I have to remove the StatLock® Stabilization Device first?
If you had a tape-secured PIV, then you surely would have to remove the tape to change the tubing.
With the StatLock® IV Ultra Stabilization Device you can keep the securement device in place while you change tubing. Simply steady the retainer with the thumb and index finger of one hand while unscrewing the extension set. Remove the set. Then, while continuing to brace the retainer, press-fit and screw in your replacement extension set. For StatLock® IV Select Stabilization Device, you will need to replace the StatLock® Stabilization Devices when you remove and replace the tubing – just as you would with tape securement; but this is a rare event offset by StatLock® Stabilization Device advantages.
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FOLEY PRODUCT:
1. How do I secure a three-way/triple lumen Foley?
Place only one or two arms of the Foley catheter in the clamp, and leave the other arm(s) on the outside of the clamp.
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2. Do I need to shave the leg?
No. Do not shave the leg due to the possibility of micro lacerations that could increase the risk of infection. Clip the hair shorter when necessary, and/or lay the hair down in the direction it grows using both skin prep pads provided. Proper use of the skin prep often prevents the need for trimming unless hair growth is excessive.
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3. Where do I place the StatLock® Stabilization Device?
It is placed on the targeted, prepped area on the anterior thigh, leaving only one inch of slack. It may also be placed on the abdomen. To ensure proper placement, be sure the patient fully extends his/her hip prior to StatLock® Stabilization Device placement. Then place the catheter into the device, and move it back up one inch before applying to the skin.
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4. Why is the 1 inch of slack so important?
The StatLock® Foley Stabilization Device is designed with a retainer clamp that swivels. This allows increased comfort for a patient as the clamp moves with him/her. However, if there is too much slack left in the catheter then the clamp may turn so much that it leads to kinking of the catheter. One inch of slack allows enough room for comfortable movement but will prevent catheter kinking.
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5. Won’t abdominal placement block urine flow?
No. The Foley drainage bag is still placed below the level of the bladder and will provide the gravity necessary for proper urine flow. Abdominal placement is necessary for some patients (i.e. pressure stockings, etc.). Abdominal placement is also preferred for chronic Foley placement in bedridden males, because it removes the downward pressure from the catheter on the meatus that often contributes to meatal erosion. Another alternative with pressure stockings is to apply a transparent dressing on top of the stocking and then apply the StatLock® Foley Stabilization Device to the transparent dressing. This is easy and works well.
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6. Can you use the StatLock® Foley Stabilization Device when pressure/tension is required in the catheter?
Yes. Pressure/tension can be applied easily with StatLock® Foley Stabilization Devices. When placing the anchor pad on the anterior thigh, keep the hip slightly flexed to the angle that achieves the appropriate pressure/tension once it is extended. Test this before applying the StatLock® Stabilization Device to the skin, so the catheter is not too taut. Once the StatLock® Stabilization Device is secure and the patient extends his/her leg, the catheter will be taut, and the desired pressure/tension
is applied.
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Place only one or two arms of the Foley catheter in the clamp, and leave the other arm(s) on the outside of the clamp.
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2. Do I need to shave the leg?
No. Do not shave the leg due to the possibility of micro lacerations that could increase the risk of infection. Clip the hair shorter when necessary, and/or lay the hair down in the direction it grows using both skin prep pads provided. Proper use of the skin prep often prevents the need for trimming unless hair growth is excessive.
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3. Where do I place the StatLock® Stabilization Device?
It is placed on the targeted, prepped area on the anterior thigh, leaving only one inch of slack. It may also be placed on the abdomen. To ensure proper placement, be sure the patient fully extends his/her hip prior to StatLock® Stabilization Device placement. Then place the catheter into the device, and move it back up one inch before applying to the skin.
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4. Why is the 1 inch of slack so important?
The StatLock® Foley Stabilization Device is designed with a retainer clamp that swivels. This allows increased comfort for a patient as the clamp moves with him/her. However, if there is too much slack left in the catheter then the clamp may turn so much that it leads to kinking of the catheter. One inch of slack allows enough room for comfortable movement but will prevent catheter kinking.
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5. Won’t abdominal placement block urine flow?
No. The Foley drainage bag is still placed below the level of the bladder and will provide the gravity necessary for proper urine flow. Abdominal placement is necessary for some patients (i.e. pressure stockings, etc.). Abdominal placement is also preferred for chronic Foley placement in bedridden males, because it removes the downward pressure from the catheter on the meatus that often contributes to meatal erosion. Another alternative with pressure stockings is to apply a transparent dressing on top of the stocking and then apply the StatLock® Foley Stabilization Device to the transparent dressing. This is easy and works well.
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6. Can you use the StatLock® Foley Stabilization Device when pressure/tension is required in the catheter?
Yes. Pressure/tension can be applied easily with StatLock® Foley Stabilization Devices. When placing the anchor pad on the anterior thigh, keep the hip slightly flexed to the angle that achieves the appropriate pressure/tension once it is extended. Test this before applying the StatLock® Stabilization Device to the skin, so the catheter is not too taut. Once the StatLock® Stabilization Device is secure and the patient extends his/her leg, the catheter will be taut, and the desired pressure/tension
is applied.
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NG PRODUCT:
1. Do I place the StatLock® NG Stabilization Device on the nose or the tube first?
First, clean the nose and the NG tube with alcohol, and then apply the skin protectant to both the nose and the tube where the StatLock® NG Stabilization Device will be placed. Once the skin protectant is completely dry, apply the StatLock® NG Stabilization Device to the nose first, by peeling away half of the paper liner and place on the skin, then peel away the remaining half and wrap the StatLock® NG Stabilization Device around the NG tube.
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2. How do I change just the StatLock® NG Stabilization Device and not the NG tube?
Carefully remove the StatLock® NG Stabilization Devices from the nose by dissolving the adhesive with alcohol. Once the anchor pad lifts off of the skin, remove the remaining portion from the tube using alcohol in the same manner. Another option is to loosen with alcohol and slide the StatLock® NG Stabilization Devices down the NG tube temporarily. You can reapply a new StatLock® Stabilization Devices to the nose and tube following the proper application steps. You would then remove the old device from the tube with alcohol.
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First, clean the nose and the NG tube with alcohol, and then apply the skin protectant to both the nose and the tube where the StatLock® NG Stabilization Device will be placed. Once the skin protectant is completely dry, apply the StatLock® NG Stabilization Device to the nose first, by peeling away half of the paper liner and place on the skin, then peel away the remaining half and wrap the StatLock® NG Stabilization Device around the NG tube.
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2. How do I change just the StatLock® NG Stabilization Device and not the NG tube?
Carefully remove the StatLock® NG Stabilization Devices from the nose by dissolving the adhesive with alcohol. Once the anchor pad lifts off of the skin, remove the remaining portion from the tube using alcohol in the same manner. Another option is to loosen with alcohol and slide the StatLock® NG Stabilization Devices down the NG tube temporarily. You can reapply a new StatLock® Stabilization Devices to the nose and tube following the proper application steps. You would then remove the old device from the tube with alcohol.
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ABOUT STATLOCK® SUTURE-FREE STABILIZATION DEVICES
1. I thought that there were only two steps to application: alcohol and skin prep? What is the tincture of benzoin for?
Tincture of benzoin adds an extra “layer” of securement to the “routine” alcohol and skin prep preparation needed for securement of StatLock® Stabilization Device sutureless products. When using the benzoin, skin prep is applied first, and allowed to dry completely in 10-15 seconds, before the tincture of benzoin is applied. The tincture of benzoin will dry “tacky dry” in about 10-15 seconds. Using both products is recommended for maximum adherence.
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2. Explain to me why the prep products need to dry, and how the skin prep dries differently from the tincture of benzoin?
Both products contain alcohol. Alcohol dissolves the adhesive during removal of the StatLock® Stabilization Devices. So, if they are not completely dry when the anchor pad is originally applied, then you could experience lifting of the pad in a short time. Skin prep dries smooth to the touch and tincture of benzoin dries “tacky dry” and remains tacky to the touch.
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3. If my patient is allergic to benzoin, then can I replace the tincture of benzoin with Mastisol?
Yes. If Mastisol is available, then it can be used in place of the tincture of benzoin.
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4. Switching from suture to this StatLock® Stabilization Device is a little scary. How do I stabilize the catheter once it’s inserted, before I get the StatLock® Stabilization Device on?
Whether it’s right after insertion or during a dressing change, it is important to stabilize the catheter with the StatLock® Stabilization Device’s sterile adhesive foam strip; place the patient in a horizontal position and reduce the tug on the line(s). Another option in lieu of the sterile adhesive foam strip for PICC silicone catheters is placement of a sterile gloved finger over the catheter. This will prevent the catheter from becoming prematurely dislodged during StatLock® Stabilization Device securement.
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5. Will this product allow me to still conduct a sterile dressing change?
Yes! You will set up your sterile field, open the new StatLock® Stabilization Device package, and place the contents of the package onto the sterile field. All StatLock® Stabilization Devices are sterile.
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6. What if my catheter is connected to a pressure transducer, will a StatLock® Stabilization Device interfere with this?
No! But to ensure a proper waveform on the monitor, it is recommended that you first attach the catheter to the StatLock® Stabilization Device, and check your waveform before peeling and pressing the anchor pad to the skin.
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7. What types of central lines do the StatLock® CV Ultra and CV Plus Stabilization Devices secure?
The StatLock® CV Ultra Stabilization Device can be used to secure certain central venous catheters and Cordis-type introducer sheaths, so it has multiple uses. The StatLock® CV Plus Stabilization Device can only secure central venous catheters (triple lumens of all sizes with suture wings will fit over the sliding posts), as Cordis and other sheaths do not properly fit the StatLock® CV Plus Stabilization Device. Generally speaking, users will not differentiate the catheters and their associated securement devices. Users will attempt to use the StatLock® CV Plus Stabilization Devices and assume they will secure a Cordis or a sheath because they were “told” it would secure central lines. The StatLock® CV Plus Stabilization Device will not properly secure the catheters other than triple-lumen CVCs, and if used by the clinician may cause catheter dislodgments, which could result in blood loss!
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8. Can I use both the StatLock® Stabilization Device anchor pad and suture together?
You can if you deem it necessary. However, the purpose of the StatLock® Stabilization Device is to eliminate sutures in order to reduce the complications and eliminate the needlestick risk associated with this practice. In fact, studies have shown that when the StatLock® Stabilization Device is properly used it secures catheters with strength comparable (if not superior) to suture-but without the associated patient complications and healthcare worker needlestick risk.
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9. If there are no sutures holding my CVC/PICC in place, won’t it fall out when I open the doors during a dressing change?
If the dressing change is properly performed, then the catheter will not migrate or dislodge. This involves three steps – Require the patient or patient’s extremity (depending on the location of the catheter) to be in a flat, horizontal or extended position; reduce the tug on the lines; and temporarily secure the catheter using a StatLock® Stabilization Device sterile adhesive strip. If the catheter is not made of silicone, then you can apply a sterile adhesive foam strip over the catheter to hold it in place until the StatLock® Stabilization Device is applied. If the catheter is made of silicone, then the sterile adhesive foam adhesive strip may be applied over the winged area near the securement holes during site care. The strip can then be removed by using the stretch technique when the StatLock® Stabilization Device is applied. Another option is to use a sterile, gloved finger to maintain catheter position during a StatLock® Stabilization Device dressing change.
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10. Can I use the StatLock® Stabilization Device sterile adhesive foam strip on a PICC silicone catheter?
No, not on the catheter. Just like with tape, the adhesive on the sterile adhesive foam strip can break down the integrity of the PICC silicone catheter, and therefore should not be used. It can, however, be placed over reinforced segments, like the wing or sleeve of the device.
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11. How do I get the catheter extension pigtail tubing into the StatLock® CV Plus Stabilization Device pigtail holder?
The pigtails (tubing) need to be stretched into the pigtail holder. Do not try to press the tubing down into the holders, as this will not work and a possible glove tear could occur.
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12. When I stretch the tubing into the pigtail holder, it looks like it “narrows” the lumen?
It indeed does look as if that’s the case, but be assured that numerous tests have been done concerning this, and these tests show that flow is not compromised for the pigtails of Arrow, Baxter, and Braun triple-lumen CVCs.
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13. When I use the Universal Plus, why do I have to wipe the catheter with skin prep?
This ensures the catheter is wet for insertion into the StatLock® Stabilization Device retainer and makes engagement into the device easier. Also, when it dries, the catheter more firmly sticks in the StatLock® Stabilization Device retainer.
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14. The StatLock® Stabilization Device nurse was talking about the “double tug” technique on the Universal Plus, what is this?
After bringing the StatLock® Stabilization Device into position, stabilize the catheter between two fingers at one end of the retainer, then “double tug” the catheter at the other end to stretch-fit into the StatLock® Stabilization Device retainer. The first tug aligns the catheter; the second tug seats it into the StatLock® Stabilization Device retainer.
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15. Do I have to immobilize the wrist when using the StatLock® Arterial Stabilization Device?
Per INS standards, a patient’s wrist must be immobilized in some fashion once the arterial line has been placed and the StatLock® Stabilization Device applied. If arm boards are not used, then it is recommended to use an arm roll made from a towel to maintain extension of the wrist. If arterial lines are not immobilized, then do not encourage use of the StatLock® Arterial Stabilization Device.
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16. After insertion of a PICC line, sometimes it oozes for the first several hours. When should I apply the StatLock® PICC Plus Stabilization Device?
Apply the StatLock® PICC Plus Stabilization Device immediately after insertion to prevent dislodgment or migration. If oozing occurs after insertion, then apply a 2x2 gauze pad over or under the catheter at the insertion site, and cover with a transparent dressing. Then, change your insertion site dressing when required per hospital policy.
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17. I want x-ray tip confirmation prior to affixing the StatLock® PICC Plus Stabilization Device, what do I do in the meantime for catheter fixation?
Prep your securement site, and secure the PICC line in the anchor pad – as instructed. Expose only a small amount of adhesive, then place on the skin to temporarily secure the anchor pad. Then cover with gauze and a transparent dressing, and obtain the x-ray. Once the catheter’s position is confirmed, remove the overlying transparent and gauze dressing, position the catheter and StatLock® Stabilization Device as appropriate, then peel away the entire liner, and firmly place the StatLock® Stabilization Device on the securement site.
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18. Are you saying a StatLock® Stabilization Device is mandatory, that the law actually requires me to use StatLock® Stabilization Devices?
No. You are not required by law to use any specific securement device. You are required to have listed as part of your Exposure Control Plan (ECP) technologies that can reduce or eliminate known accidental needlestick RISKS. That said, if you do not have sutureless securement in your ECP, then OSHA may cite you for violation of the Bloodborne Pathogen Standard.
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19. So what is actually recommended?
The law requires:
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20. Is it only OSHA I should be concerned about?
The new JCAHO 2004 Hospital Accreditation Standards (p. 215) require all facilities to “comply with the appropriate laws and regulations.” If an OSHA citation for non-compliance to the Needlestick Safety and Prevention Law and Blood borne Pathogen Standard, and you cannot meet JCAHO Standard LD.1.30. To be perfectly clear, failure to meet OSHA’s requirements places your institution in jeopardy of not getting JCAHO accreditation.
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21. If I implement StatLock® Stabilization Devices, then am I automatically OSHA compliant?
Yes, but only with regard to securement; and possibly, only for a year. If a new technology comes around that addresses a hazard the StatLock® Stabilization Device does not address, then it will need to be placed on your ECP for evaluation. But this answer holds for all safety products you implement. An annual update of your ECP to evaluate new technologies is required.
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22. What is the legal/regulatory bottom line?
The bottom line is this: OSHA is citing and fining hospitals for suture-securing CVCs, arterial lines, PICCs, dialysis catheters, chest tubes “and other applications.” The smart and right thing to do is put the StatLock® Stabilization Device on your ECP at once. Then, as quickly as possible, determine if the StatLock® Stabilization Device is appropriate and feasible. If the StatLock® Stabilization Device works, then implement it. If the StatLock® Stabilization Device doesn’t work (which almost NEVER HAPPENS), then write down your reasons in your ECP. Do this, and with regard to securement, then you are OSHA safe.
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Tincture of benzoin adds an extra “layer” of securement to the “routine” alcohol and skin prep preparation needed for securement of StatLock® Stabilization Device sutureless products. When using the benzoin, skin prep is applied first, and allowed to dry completely in 10-15 seconds, before the tincture of benzoin is applied. The tincture of benzoin will dry “tacky dry” in about 10-15 seconds. Using both products is recommended for maximum adherence.
back to top
2. Explain to me why the prep products need to dry, and how the skin prep dries differently from the tincture of benzoin?
Both products contain alcohol. Alcohol dissolves the adhesive during removal of the StatLock® Stabilization Devices. So, if they are not completely dry when the anchor pad is originally applied, then you could experience lifting of the pad in a short time. Skin prep dries smooth to the touch and tincture of benzoin dries “tacky dry” and remains tacky to the touch.
back to top
3. If my patient is allergic to benzoin, then can I replace the tincture of benzoin with Mastisol?
Yes. If Mastisol is available, then it can be used in place of the tincture of benzoin.
back to top
4. Switching from suture to this StatLock® Stabilization Device is a little scary. How do I stabilize the catheter once it’s inserted, before I get the StatLock® Stabilization Device on?
Whether it’s right after insertion or during a dressing change, it is important to stabilize the catheter with the StatLock® Stabilization Device’s sterile adhesive foam strip; place the patient in a horizontal position and reduce the tug on the line(s). Another option in lieu of the sterile adhesive foam strip for PICC silicone catheters is placement of a sterile gloved finger over the catheter. This will prevent the catheter from becoming prematurely dislodged during StatLock® Stabilization Device securement.
back to top
5. Will this product allow me to still conduct a sterile dressing change?
Yes! You will set up your sterile field, open the new StatLock® Stabilization Device package, and place the contents of the package onto the sterile field. All StatLock® Stabilization Devices are sterile.
back to top
6. What if my catheter is connected to a pressure transducer, will a StatLock® Stabilization Device interfere with this?
No! But to ensure a proper waveform on the monitor, it is recommended that you first attach the catheter to the StatLock® Stabilization Device, and check your waveform before peeling and pressing the anchor pad to the skin.
back to top
7. What types of central lines do the StatLock® CV Ultra and CV Plus Stabilization Devices secure?
The StatLock® CV Ultra Stabilization Device can be used to secure certain central venous catheters and Cordis-type introducer sheaths, so it has multiple uses. The StatLock® CV Plus Stabilization Device can only secure central venous catheters (triple lumens of all sizes with suture wings will fit over the sliding posts), as Cordis and other sheaths do not properly fit the StatLock® CV Plus Stabilization Device. Generally speaking, users will not differentiate the catheters and their associated securement devices. Users will attempt to use the StatLock® CV Plus Stabilization Devices and assume they will secure a Cordis or a sheath because they were “told” it would secure central lines. The StatLock® CV Plus Stabilization Device will not properly secure the catheters other than triple-lumen CVCs, and if used by the clinician may cause catheter dislodgments, which could result in blood loss!
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8. Can I use both the StatLock® Stabilization Device anchor pad and suture together?
You can if you deem it necessary. However, the purpose of the StatLock® Stabilization Device is to eliminate sutures in order to reduce the complications and eliminate the needlestick risk associated with this practice. In fact, studies have shown that when the StatLock® Stabilization Device is properly used it secures catheters with strength comparable (if not superior) to suture-but without the associated patient complications and healthcare worker needlestick risk.
back to top
9. If there are no sutures holding my CVC/PICC in place, won’t it fall out when I open the doors during a dressing change?
If the dressing change is properly performed, then the catheter will not migrate or dislodge. This involves three steps – Require the patient or patient’s extremity (depending on the location of the catheter) to be in a flat, horizontal or extended position; reduce the tug on the lines; and temporarily secure the catheter using a StatLock® Stabilization Device sterile adhesive strip. If the catheter is not made of silicone, then you can apply a sterile adhesive foam strip over the catheter to hold it in place until the StatLock® Stabilization Device is applied. If the catheter is made of silicone, then the sterile adhesive foam adhesive strip may be applied over the winged area near the securement holes during site care. The strip can then be removed by using the stretch technique when the StatLock® Stabilization Device is applied. Another option is to use a sterile, gloved finger to maintain catheter position during a StatLock® Stabilization Device dressing change.
back to top
10. Can I use the StatLock® Stabilization Device sterile adhesive foam strip on a PICC silicone catheter?
No, not on the catheter. Just like with tape, the adhesive on the sterile adhesive foam strip can break down the integrity of the PICC silicone catheter, and therefore should not be used. It can, however, be placed over reinforced segments, like the wing or sleeve of the device.
back to top
11. How do I get the catheter extension pigtail tubing into the StatLock® CV Plus Stabilization Device pigtail holder?
The pigtails (tubing) need to be stretched into the pigtail holder. Do not try to press the tubing down into the holders, as this will not work and a possible glove tear could occur.
back to top
12. When I stretch the tubing into the pigtail holder, it looks like it “narrows” the lumen?
It indeed does look as if that’s the case, but be assured that numerous tests have been done concerning this, and these tests show that flow is not compromised for the pigtails of Arrow, Baxter, and Braun triple-lumen CVCs.
back to top
13. When I use the Universal Plus, why do I have to wipe the catheter with skin prep?
This ensures the catheter is wet for insertion into the StatLock® Stabilization Device retainer and makes engagement into the device easier. Also, when it dries, the catheter more firmly sticks in the StatLock® Stabilization Device retainer.
back to top
14. The StatLock® Stabilization Device nurse was talking about the “double tug” technique on the Universal Plus, what is this?
After bringing the StatLock® Stabilization Device into position, stabilize the catheter between two fingers at one end of the retainer, then “double tug” the catheter at the other end to stretch-fit into the StatLock® Stabilization Device retainer. The first tug aligns the catheter; the second tug seats it into the StatLock® Stabilization Device retainer.
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15. Do I have to immobilize the wrist when using the StatLock® Arterial Stabilization Device?
Per INS standards, a patient’s wrist must be immobilized in some fashion once the arterial line has been placed and the StatLock® Stabilization Device applied. If arm boards are not used, then it is recommended to use an arm roll made from a towel to maintain extension of the wrist. If arterial lines are not immobilized, then do not encourage use of the StatLock® Arterial Stabilization Device.
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16. After insertion of a PICC line, sometimes it oozes for the first several hours. When should I apply the StatLock® PICC Plus Stabilization Device?
Apply the StatLock® PICC Plus Stabilization Device immediately after insertion to prevent dislodgment or migration. If oozing occurs after insertion, then apply a 2x2 gauze pad over or under the catheter at the insertion site, and cover with a transparent dressing. Then, change your insertion site dressing when required per hospital policy.
back to top
17. I want x-ray tip confirmation prior to affixing the StatLock® PICC Plus Stabilization Device, what do I do in the meantime for catheter fixation?
Prep your securement site, and secure the PICC line in the anchor pad – as instructed. Expose only a small amount of adhesive, then place on the skin to temporarily secure the anchor pad. Then cover with gauze and a transparent dressing, and obtain the x-ray. Once the catheter’s position is confirmed, remove the overlying transparent and gauze dressing, position the catheter and StatLock® Stabilization Device as appropriate, then peel away the entire liner, and firmly place the StatLock® Stabilization Device on the securement site.
back to top
18. Are you saying a StatLock® Stabilization Device is mandatory, that the law actually requires me to use StatLock® Stabilization Devices?
No. You are not required by law to use any specific securement device. You are required to have listed as part of your Exposure Control Plan (ECP) technologies that can reduce or eliminate known accidental needlestick RISKS. That said, if you do not have sutureless securement in your ECP, then OSHA may cite you for violation of the Bloodborne Pathogen Standard.
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19. So what is actually recommended?
The law requires:
- A detailed log of Sharps injuries
- Healthcare worker input into the Sharps Safety Program
- A detailed Exposure Control Plan (ECP) that includes new technologies that can reduce or eliminate RISK or at least annual updating of the ECP
- An annual review of catheter securement
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20. Is it only OSHA I should be concerned about?
The new JCAHO 2004 Hospital Accreditation Standards (p. 215) require all facilities to “comply with the appropriate laws and regulations.” If an OSHA citation for non-compliance to the Needlestick Safety and Prevention Law and Blood borne Pathogen Standard, and you cannot meet JCAHO Standard LD.1.30. To be perfectly clear, failure to meet OSHA’s requirements places your institution in jeopardy of not getting JCAHO accreditation.
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21. If I implement StatLock® Stabilization Devices, then am I automatically OSHA compliant?
Yes, but only with regard to securement; and possibly, only for a year. If a new technology comes around that addresses a hazard the StatLock® Stabilization Device does not address, then it will need to be placed on your ECP for evaluation. But this answer holds for all safety products you implement. An annual update of your ECP to evaluate new technologies is required.
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22. What is the legal/regulatory bottom line?
The bottom line is this: OSHA is citing and fining hospitals for suture-securing CVCs, arterial lines, PICCs, dialysis catheters, chest tubes “and other applications.” The smart and right thing to do is put the StatLock® Stabilization Device on your ECP at once. Then, as quickly as possible, determine if the StatLock® Stabilization Device is appropriate and feasible. If the StatLock® Stabilization Device works, then implement it. If the StatLock® Stabilization Device doesn’t work (which almost NEVER HAPPENS), then write down your reasons in your ECP. Do this, and with regard to securement, then you are OSHA safe.
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ABOUT ALL STATLOCK® STABILIZATION DEVICES
1. Why is it important to let the alcohol/ChloraPrep® and skin prep dry before applying the StatLock® Stabilization Device?
If products that contain alcohol aren’t allowed to completely dry, before adhering the StatLock® Stabilization Device, then you could experience lifting of the pad in a short time. This is due to the alcohol dissolving the adhesive in the anchor pad. To eliminate this risk, it is recommended that you allow the alcohol/ChloraPrep®, skin prep and tincture of benzoin to dry completely before adhering the securement pad.
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2. Can I use ChloraPrep® instead of alcohol for securement site preparation?
Yes. The first recommended step for skin preparation for StatLock® Stabilization Device use is to cleanse the skin using isopropyl alcohol to remove betadine, oils, lotions and any secretions. Recent questions have been raised as to whether 2% Chlorhexidine (e.g. ChloraPrep®) can be used instead of alcohol for StatLock® Stabilization Device skin preparation. Extensive, in-house, wear testing has been performed in order to answer this question definitively. ChloraPrep® equivalently performed to alcohol as a skin prep solution with respect to StatLock® Stabilization Device adhesion. In view of the CDC recommendation for use of ChloraPrep®, it would now seem the preferred choice is to use ChloraPrep® as a preparatory solution to a StatLock® Stabilization Device.
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3. What is in the skin prep that is included in the StatLock® Stabilization Device package?
The skin prep is a product that contains three ingredients – 70% isopropyl alcohol, a plastic polymer, and a preservative. It provides an acrylic layer on top of the skin. This serves as a skin protectant. It also bonds with the acrylic in the adhesive on the back of the anchor pad to create the firm hold seen with the StatLock® Stabilization Device product line. When using skin preparation, always cover a generous surface area. Using skin prep on a bigger surface area than what the StatLock® Stabilization Device anchor pad will cover can help prevent any premature lifting around the edges of the pad.
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4. Do many patients have an allergy to the skin prep?
No. With respect to skin prep, this product contains three ingredients – 70% isopropyl alcohol, a plastic polymer, and a preservative. None of these ingredients is considered an irritant; in fact, with the rare exception of the preservative–skin irritation/allergy, as a result of contact with this product, is virtually unheard of. With regard to the StatLock® Stabilization Device adhesive, it is latex free and hypoallergenic. With millions of StatLock® Stabilization Devices being sold each year, the reported incidence of skin irritation/allergy to the StatLock® Stabilization Device adhesive is less than 1/10 of 1%. It should be noted that when such skin irritation/allergy does occur, the customer is frequently unable to distinguish the precise cause. This is because multiple agents may have contacted the skin during StatLock® Stabilization Device usage: for example betadine, chlorhexidine, or tincture of benzoin – anyone of which can cause irritation/allergy. We continue to advise StatLock® Stabilization Devices be contraindicated in patients with a known tape or adhesive allergy.
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5. Why should I remove the betadine before I use the skin prep?
Betadine dries as a powder and interferes with StatLock® Stabilization Device adherence, so it must be removed properly from the securement area before applying StatLock® Stabilization Devices or the pad may prematurely lift. If used at the insertion site, restrict application to that area and not the securement site, to make removal prior to the StatLock® Stabilization Device application easier.
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6. Since the StatLock® Stabilization Device is a dressing, do I still need to use a transparent dressing for the insertion site?
A transparent dressing to cover the insertion site may still be required per hospital policy. The StatLock® Stabilization Device is not a replacement product for the transparent dressing. The StatLock® Stabilization Device replaces the tape or suture used to secure the catheter, not the insertion site dressing. Supplies and practices currently utilized while inserting catheters (including transparent dressings) should continue to be adhered to per hospital guidelines. The StatLock® Stabilization Device works at the securement site, which is separate and distinct from the insertion site.
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7. Will the transparent dressing hurt the StatLock® Stabilization Device anchor pad? What if it sticks to the plastic retainer or doors on the anchor pad?
The transparent dressing will not hurt the StatLock® Stabilization Device anchor pad. The transparent dressing can be placed adjacent to OR over the StatLock® Stabilization Device anchor pad if your hospital policy dictates. If the transparent dressing tightly adheres to any StatLock® Stabilization Device plastic components on the anchor pad, then apply alcohol on top of the dressing, just over the plastic. This will allow the dressing to release easily. Use the “stretch technique” to remove the transparent dressing. Alcohol is recommended to lift the edges of the dressing. With edges loosened, tangentially stretch sides of dressing to remove, starting at the distal edge of the dressing and working towards the insertion site.
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8. How do you keep the adhesive from causing skin tears?
Using a lot of alcohol! The StatLock® Stabilization Device works well on patients with thin, fragile skin, as long as a large amount of alcohol is used for removal – 2 to 4 alcohol pads each time. When properly removed with enough alcohol, skin tears can be eliminated. For proper removal it is best to use several alcohol pads and “pool” or “squeeze” the alcohol around the edges to first lift the pad at a corner. Then work the alcohol from underneath to dissolve the adhesive. Use a back-and-forth motion under the pad as it lifts off. Do not pull or force the pad, gently lift as the alcohol dissolves the adhesive. Continue to squeeze the alcohol pad and let the alcohol do most of the work for you.
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9. What is the difference between a “tricot” anchor pad and a “closed cell foam” anchor pad?
A tricot anchor pad is a moisture–resistant pad and breathable, whereas a closed cell foam
anchor pad is moisture proof and occlusive. Both are proven StatLock® Stabilization Device performers.
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10. How do I clean the StatLock® Stabilization Device anchor pad?
You can clean the anchor pad with sterile saline or hydrogen peroxide. DO NOT USE
ALCOHOL OR ANY DERIVITIVE OF ALCOHOL TO CLEAN, INCLUDING ANY BAG BATH PRODUCTS.
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11. Can patients bathe with the StatLock® Stabilization Device on?
Yes, but only if he/she places a waterproof dressing over the StatLock® Stabilization Device before bathing.
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12. Are there any instances when I’d have to change the StatLock® Stabilization Device more frequently than what my insertion site dressing change hospital policy states?
Always refer to your hospital policy and procedure. As a general rule of thumb, the StatLock® Stabilization Device should be monitored daily and changed as clinically indicated at least every 7 days. Remind users that patients get cooled down for surgery, and when they heat up and their body temperatures rise, and they may become diaphoretic (sometimes excessively, depending on their specific illness, etc.). The StatLock® Stabilization Device may need to be changed accordingly. For PICCs, the StatLock® Stabilization Device generally lasts 7 days. For most ICU applications, you may want to change the StatLock® Stabilization Device with every other dressing change.
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13. Why do I have to connect the StatLock® Stabilization Device to the tubing or catheter before I place the StatLock® Stabilization Device on the skin?
Once the pad is adhered to the skin you may not be able to line it up properly to attach to the catheter. So, first connect the catheter to the StatLock® Stabilization Device, then the StatLock® Stabilization Device to the skin. This step also protects a patient and reduces any unnecessary pressure on his/her skin.
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14. Can I use adhesive remover in place of alcohol for StatLock® Stabilization Device removal?
Yes. Adhesive remover will work even better to remove a StatLock® Stabilization Device than alcohol alone. Adhesive remover is recommended for any patient where StatLock® Stabilization Device removal with alcohol is difficult.
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15. Do comfort bath products raise any concern; I know they contain a lot of oils?
Yes. Nothing sticks to the skin when these products are used. It is even more important to use a generous amount of alcohol, or even soap and water, to remove the oils before StatLock® Stabilization Device is applied. It is also important to keep these products away from the securement site as much as possible during bathing. The oils and lanolin migrate on the skin and could prematurely loosen the anchor pad, and cause lifting around the edges - just as it does with tape.
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If products that contain alcohol aren’t allowed to completely dry, before adhering the StatLock® Stabilization Device, then you could experience lifting of the pad in a short time. This is due to the alcohol dissolving the adhesive in the anchor pad. To eliminate this risk, it is recommended that you allow the alcohol/ChloraPrep®, skin prep and tincture of benzoin to dry completely before adhering the securement pad.
back to top
2. Can I use ChloraPrep® instead of alcohol for securement site preparation?
Yes. The first recommended step for skin preparation for StatLock® Stabilization Device use is to cleanse the skin using isopropyl alcohol to remove betadine, oils, lotions and any secretions. Recent questions have been raised as to whether 2% Chlorhexidine (e.g. ChloraPrep®) can be used instead of alcohol for StatLock® Stabilization Device skin preparation. Extensive, in-house, wear testing has been performed in order to answer this question definitively. ChloraPrep® equivalently performed to alcohol as a skin prep solution with respect to StatLock® Stabilization Device adhesion. In view of the CDC recommendation for use of ChloraPrep®, it would now seem the preferred choice is to use ChloraPrep® as a preparatory solution to a StatLock® Stabilization Device.
back to top
3. What is in the skin prep that is included in the StatLock® Stabilization Device package?
The skin prep is a product that contains three ingredients – 70% isopropyl alcohol, a plastic polymer, and a preservative. It provides an acrylic layer on top of the skin. This serves as a skin protectant. It also bonds with the acrylic in the adhesive on the back of the anchor pad to create the firm hold seen with the StatLock® Stabilization Device product line. When using skin preparation, always cover a generous surface area. Using skin prep on a bigger surface area than what the StatLock® Stabilization Device anchor pad will cover can help prevent any premature lifting around the edges of the pad.
back to top
4. Do many patients have an allergy to the skin prep?
No. With respect to skin prep, this product contains three ingredients – 70% isopropyl alcohol, a plastic polymer, and a preservative. None of these ingredients is considered an irritant; in fact, with the rare exception of the preservative–skin irritation/allergy, as a result of contact with this product, is virtually unheard of. With regard to the StatLock® Stabilization Device adhesive, it is latex free and hypoallergenic. With millions of StatLock® Stabilization Devices being sold each year, the reported incidence of skin irritation/allergy to the StatLock® Stabilization Device adhesive is less than 1/10 of 1%. It should be noted that when such skin irritation/allergy does occur, the customer is frequently unable to distinguish the precise cause. This is because multiple agents may have contacted the skin during StatLock® Stabilization Device usage: for example betadine, chlorhexidine, or tincture of benzoin – anyone of which can cause irritation/allergy. We continue to advise StatLock® Stabilization Devices be contraindicated in patients with a known tape or adhesive allergy.
back to top
5. Why should I remove the betadine before I use the skin prep?
Betadine dries as a powder and interferes with StatLock® Stabilization Device adherence, so it must be removed properly from the securement area before applying StatLock® Stabilization Devices or the pad may prematurely lift. If used at the insertion site, restrict application to that area and not the securement site, to make removal prior to the StatLock® Stabilization Device application easier.
back to top
6. Since the StatLock® Stabilization Device is a dressing, do I still need to use a transparent dressing for the insertion site?
A transparent dressing to cover the insertion site may still be required per hospital policy. The StatLock® Stabilization Device is not a replacement product for the transparent dressing. The StatLock® Stabilization Device replaces the tape or suture used to secure the catheter, not the insertion site dressing. Supplies and practices currently utilized while inserting catheters (including transparent dressings) should continue to be adhered to per hospital guidelines. The StatLock® Stabilization Device works at the securement site, which is separate and distinct from the insertion site.
back to top
7. Will the transparent dressing hurt the StatLock® Stabilization Device anchor pad? What if it sticks to the plastic retainer or doors on the anchor pad?
The transparent dressing will not hurt the StatLock® Stabilization Device anchor pad. The transparent dressing can be placed adjacent to OR over the StatLock® Stabilization Device anchor pad if your hospital policy dictates. If the transparent dressing tightly adheres to any StatLock® Stabilization Device plastic components on the anchor pad, then apply alcohol on top of the dressing, just over the plastic. This will allow the dressing to release easily. Use the “stretch technique” to remove the transparent dressing. Alcohol is recommended to lift the edges of the dressing. With edges loosened, tangentially stretch sides of dressing to remove, starting at the distal edge of the dressing and working towards the insertion site.
back to top
8. How do you keep the adhesive from causing skin tears?
Using a lot of alcohol! The StatLock® Stabilization Device works well on patients with thin, fragile skin, as long as a large amount of alcohol is used for removal – 2 to 4 alcohol pads each time. When properly removed with enough alcohol, skin tears can be eliminated. For proper removal it is best to use several alcohol pads and “pool” or “squeeze” the alcohol around the edges to first lift the pad at a corner. Then work the alcohol from underneath to dissolve the adhesive. Use a back-and-forth motion under the pad as it lifts off. Do not pull or force the pad, gently lift as the alcohol dissolves the adhesive. Continue to squeeze the alcohol pad and let the alcohol do most of the work for you.
back to top
9. What is the difference between a “tricot” anchor pad and a “closed cell foam” anchor pad?
A tricot anchor pad is a moisture–resistant pad and breathable, whereas a closed cell foam
anchor pad is moisture proof and occlusive. Both are proven StatLock® Stabilization Device performers.
back to top
10. How do I clean the StatLock® Stabilization Device anchor pad?
You can clean the anchor pad with sterile saline or hydrogen peroxide. DO NOT USE
ALCOHOL OR ANY DERIVITIVE OF ALCOHOL TO CLEAN, INCLUDING ANY BAG BATH PRODUCTS.
back to top
11. Can patients bathe with the StatLock® Stabilization Device on?
Yes, but only if he/she places a waterproof dressing over the StatLock® Stabilization Device before bathing.
back to top
12. Are there any instances when I’d have to change the StatLock® Stabilization Device more frequently than what my insertion site dressing change hospital policy states?
Always refer to your hospital policy and procedure. As a general rule of thumb, the StatLock® Stabilization Device should be monitored daily and changed as clinically indicated at least every 7 days. Remind users that patients get cooled down for surgery, and when they heat up and their body temperatures rise, and they may become diaphoretic (sometimes excessively, depending on their specific illness, etc.). The StatLock® Stabilization Device may need to be changed accordingly. For PICCs, the StatLock® Stabilization Device generally lasts 7 days. For most ICU applications, you may want to change the StatLock® Stabilization Device with every other dressing change.
back to top
13. Why do I have to connect the StatLock® Stabilization Device to the tubing or catheter before I place the StatLock® Stabilization Device on the skin?
Once the pad is adhered to the skin you may not be able to line it up properly to attach to the catheter. So, first connect the catheter to the StatLock® Stabilization Device, then the StatLock® Stabilization Device to the skin. This step also protects a patient and reduces any unnecessary pressure on his/her skin.
back to top
14. Can I use adhesive remover in place of alcohol for StatLock® Stabilization Device removal?
Yes. Adhesive remover will work even better to remove a StatLock® Stabilization Device than alcohol alone. Adhesive remover is recommended for any patient where StatLock® Stabilization Device removal with alcohol is difficult.
back to top
15. Do comfort bath products raise any concern; I know they contain a lot of oils?
Yes. Nothing sticks to the skin when these products are used. It is even more important to use a generous amount of alcohol, or even soap and water, to remove the oils before StatLock® Stabilization Device is applied. It is also important to keep these products away from the securement site as much as possible during bathing. The oils and lanolin migrate on the skin and could prematurely loosen the anchor pad, and cause lifting around the edges - just as it does with tape.
back to top