Authors (including presenting author) :
Lui SF ,Wong MC, Lam PYW, Li SP
Affiliation :
Department of Clinical Oncology, Tuen Mun Hospital, New Territories West Cluster, Hospital Authority, Hong Kong SAR
Introduction :
Central Venous Access Device (CVAD) is used for oncology patients for receiving intravenous chemotherapy, targeted therapy & TPN (Total Parenteral Nutrition). As patients usually come across difficulty for venous access, Peripherally Inserted Central Catheter (PICC) is the most common used device among all CVAD in patient setting of acute Oncology ward in Tuen Mun Hospital. In 2018, In patient PICC line infection is 12.5% with the use of transparent dressing with secured lock material. Trial program for the use of dressing with Chlorhexidine Gluconate gel pad (CHG) in 2019 as to promote the PICC site nursing care.
Objectives :
To implement high standard of central catheter site care with CHG dressing material..
To enhance the antiseptic environment of the PICC site wound as to prevent catheter site related infection.
Methodology :
A9 ward -based Trial program to work through in 2019 with a team of trained nurses.
Preparation : 1 month
In January, nurse training for the use of the CHG dressing material ,flowchart of patient care & assessment form with evaluation of nurses before the program launched.
Implementation :8 months
From February to October, nine cases are recruited with newly inserted PICC. Consent obtained for use of Chlorhexidine Gluconate pad dressing with dressing changed every seven day in A9 ward.
Evaluation : 1 month
In November, nurse feedback & patient data are collected for analysis.
Result & Outcome :
Patient data: Nine cases, five female & four male, with newly PICC inserted recruited. No complications after PICC insertion. Initial PICC site dressing with Chlorhexidine Gluconate pad before discharge & related PICC site care education given to patient. Three days phone follow up results: No skin reaction, allergic or infection signs reported. Reinforcement of PICC site care given to patient. Every seventh day dressing: No infection cases reported. Two cases with signs of contact Dermatitis with non- Chlorhexidine Gluconate pad dressing changed. Overall Patient feedback: Positive feedback from patients of comfortable pad & non bulky deign secured on upper limb which make them easy for grooming. Overall evaluation: Zero infection cases of PICC Chlorhexidine Gluconate pad dressing which shows that good antiseptic effect of the dressing in preventing site related infection & enhances PICC site nursing care. However, further case review should be worked out for contact dermatitis effect of the dressing material.
