Improving Vascular Access Dressing Integrity in the Acute Care Setting: A Quality Improvement Project.
Michelle DeVries, Jill Sarbenoff, Nancy Scott and 2 others
PMID 34198309WHAT IT FOUND
For nurses managing peripheral IV dressings, adding gum mastic adhesive to transparent dressings reached 93% and 83% intact in small protocol samples, while education alone reached 57% and 9%.
Key findings
01Education with the original 3M dressing reached 57% intact (76/134), and the updated 3M dressing alone reached 9% intact (1/11).
02Adding gum mastic adhesive achieved 93% intact (26/28) with the Centurion dressing and 83% intact (19/23) with the updated 3M dressing.
03After standardizing the updated 3M dressing with adhesive and education, 29081 of 30049 vascular access sites had fully intact dressings (96.78%).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This was a quality improvement project, not a randomized controlled trial, so it cannot show that the adhesive alone caused the improvement. The four protocols were introduced one after another, so education, dressing product, adhesive, and time changed together. The protocol samples were small, especially the updated dressing alone (1/11), and one protocol was stopped early. The main outcome was dressing appearance at day 7 or device removal, not bloodstream infection or patient harm. Nurses knew the goal and were educated by the project team, and unit-reported integrity may be inflated. Skin injury data came from reports, consults, and rounds; later cases show medical adhesive-related skin injuries were not impossible.
Declared interests
No funding was received. One author disclosed speaker bureau affiliations with Becton Dickinson, Eloquest, Ethicon, Smiths Medical, The Clinician Exchange, 3M, and Teleflex, plus unrelated grant funding from Johnson & Johnson and honoraria from Kurin; the remaining authors reported no conflicts. Manufacturer clinical support staff helped educate nurses during the project.
The easy way to misread this
Do not conclude that adding gum mastic adhesive prevents bloodstream infections. This quality improvement project measured dressing integrity and reported skin complications, not infection rates, and the protocols were introduced sequentially without a control group.