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New Device Is Safer than Tape or Sutures in Securing Catheters in Ill Children, According to Researchers from The Children's Hospital of Philadelphia
Philadelphia, Pa. -- A self-adhesive device called StatLock(r) may be preferable to using sterile tape or sutures to secure intravenous catheters that deliver nutritional fluids and medications to patients. Compared to those standard methods, the device reduced infection rates in patients and was dislodged less frequently, according to researchers from The Children's Hospital of Philadelphia. In addition, nurses and physicians completely avoided the risk of accidental needlesticks that may occur when inserting sutures. "We found advantages for both patients and healthcare providers," said Gregory J. Schears, M.D., an intensive-care physician in the Division of Critical Care Medicine at Children's Hospital, and lead author of the study.
Dr. Schears presented his study results today at a national conference on patient safety in Chicago, co-sponsored by the National Patient Safety Foundation and the Joint Commission on Accreditation of Healthcare Organizations.
Two studies were performed in 200 pediatric patients at Children's Hospital, with a third study group composed of 148 adult patients at the Hospital of the University of Pennsylvania. Patients were randomly assigned to receive either the StatLock device or the conventional securement method -- sterile threaded tape or sutures. "Overall, when patients had the StatLock, there were fewer catheter-related complications, such as infections, unplanned removals and accidental needlesticks," said Dr. Schears. "The device was also significantly faster to apply than either tape or sutures."
Central venous catheters are used to annually deliver intravenous fluids, nutritional fluids and medication to millions of patients, many of them critically ill. However, puncturing the skin and maintaining an opening for the catheter runs a risk of potentially serious infection. "Until now, no studies have systematically compared current securement methods for their impact on catheter-related complications," said Dr. Schears. "Taping requires less equipment than sutures, and is easier to perform, but may be less secure. Suturing is uncomfortable for the patient, and the site may become inflamed. Additionally, suturing carries the risk of a needlestick injury to the healthcare provider." Needlestick injuries to healthcare workers entail a risk of transmitting infectious disease such as hepatitis or HIV, and require expensive post-exposure treatment.
The StatLock device, says Dr. Schears, combines the ease and safety of tape application with the strength of sutures. An adhesive pad provides a broad surface area to attach to the skin, and raises the catheter off the skin while holding the catheter in plastic prongs. The device must be removed and replaced every week, and the dressing changed. In addition to StatLock's health benefits, Dr. Schears found lower costs associated with maintenance and complications. For instance, although total average costs were similar, complication costs for StatLock averaged $71, compared to $328 for tape.
StatLock is manufactured by Venetec International, a medical device company in San Diego, California, which funded the study by Dr. Schears' team. Co-authors of the study are Mark Helfaer, M.D.; Catherine Liebig; Ann Marie Frey, R.N., B.S.N.; Rosetta Chiavacci, R.N., B.S.N.; Kathleen Harris, R.N., B.S.N.; Richard Lin, M.D.; and Andrew Costarino, M.D. The co-authors are from the Department of Anesthesia and Critical Care Medicine and the Department of Nursing at The Children's Hospital of Philadelphia.
The Children's Hospital of Philadelphia, the nation's first children's hospital, is a leader in patient care, education and research. This 381-bed multispecialty hospital provides comprehensive pediatric services, including home care, to children from before birth through age 19. The hospital is second in the United States among all children's hospitals in total research funding from the National Institutes of Health.
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