You are a vascular access nurse. You work hard to make life easier for all the other nurses and clinicians at your hospital. You are the expert that they call in to place difficult IVs and complete dressing changes on various central lines.
Now, imagine that you had to work the night shift and you are *almost* done with your day. You had a day of hard work, all went well, and you are eager to finally get to go home and see your family take off for the day. One. more. hour. and you can get some much-needed rest.
You only have one last PICC line dressing change and you are home free. This patient is one of your favorites, he always asks how your day went and always wants to chat, despite his condition. He is an oncology patient with stage four lung cancer who is fighting for his life. He has gone through so many trials and tribulations during his battle, so this dressing change is no biggie for you or him.
So, you go about the dressing change according to your facility’s best practices and all is going well, just up until you get to the securement device. You always dread this part because you’ve had issues with this device in the past. You try to open the gates on the securement device and they are stuck. You try adding just a little bit more force to get them to open up, and…
That little bit of extra upward force was all it took for your thumb to catch underneath the catheter and slightly pull it out of the patient. But, it doesn’t look too bad… right?
The gates are finally open, so you complete the dressing change. That securement device has been on the patient for seven days, so it is pretty darn stuck. You grab a bunch of alcohol prep pads and carefully start to saturate the adhesive on the device and try to remove the device, little by little, separating it from the patient’s skin.
The patient’s skin is irritated. You can tell that his battle has been going on for some time just by looking at his arm. His skin is discolored, it’s irritated, and there are signs of skin tears. The poor guy, he is already so delicate and this device removal is just adding to his pain. When you finally get the device off of the patient, you can see all the different places the securement device has been placed during previous dressing changes. It appears that every time it has caused some irritation and the device gets moved to another spot.
You complete the dressing change, feeling slightly guilty, as you are putting on another one of those devices right back on him. But, it’s your job and it is the product that your hospital has chosen to use.
Your job is not over. Yes, you completed the dressing change, but you know that you moved the catheter. What was supposed to be a simple dressing change just got a whole lot more complicated.
Every shift measures and documents the exposed catheter length. You take a measurement and compare it to the last shift, and… dangit. It moved too much. Now you get to tell the patient, the MD, and radiology that the catheter migrated. You have to explain to your patient that he needs to get yet another x-ray.
Radiology schedules another chest x-ray to confirm the tip location, and the results say what you were dreading. The catheter needs to be pulled and replaced. You have to tell your patient that you need to remove their catheter and reinsert a new one. Your patient is stressed because they have to sit through another uncomfortable insertion, you are stressed because you feel like this is your fault and you are causing the discomfort, and this whole situation shouldn’t have even happened!
You check the clock and slump in defeat. It’s already well past the end of your shift. You’re gonna miss seeing your family this morning. You won’t be able to hug your kids goodbye as they run off to school.
Dejected, you start prepping your patient for a new catheter insertion and grimace as you see that same device in your PICC line insertion tray. That device with the gates from hell that ruined your day, your patient’s day, and your kid’s day because they didn’t get to see their mom before school.
Things like this happened to the best of us, and they happen regularly during the course of care. We try to make the best out of what we have, but sometimes that’s not even enough!
The manufacturers of these devices know about these issues. They receive complaints, frequent complaints, about how difficult their device is to remove. About how the adhesive is so harsh that it causes skin tears.
Manufacturers need to make catheter securement devices that don’t cause “expected stress of managing”. So, that’s what we did. At Starboard Medical, we listen. We listened and learned and designed a catheter securement device that strives to help reduce these issues.
We developed Clik-FIX. It is a catheter securement device that was specifically designed with patient care in mind, as well as ease of use for the clinician. The base of the device contains a foam cushion to reduce the risk of pressure ulcers to the patient. The mechanical locking mechanism can be easily opened in just one second with just one finger. The adhesive is one degree less than “that” device.
The locking mechanism opens in a way that doesn’t require any upward force, only a soft lateral force.