THE USE OF TISSUE ADHESIVE FOR PERIPHERAL INTRAVENOUS AND ARTERIAL CATHETERS:
A SURVEY OF CLINICIAN EXPERIENCE Lori Kaczmarek, MSN, RN, VA-BC™ | Vascular Access Clinical Specialist, Adhezion Biomedical, LLC
INTRODUCTION Recent editions of Intravascular Quarterly (IQ) included reports about the clinician experience and patient outcomes using tissue adhesive (TA) in the neonatal population and another described TA use to manage post device insertion bleeding and oozing in adults. 1, 2 This report seeks to understand the impact of TA on peripheral intravenous (PIV) and arterial catheters (AC).
PERIPHERAL AND ARTERIAL CATHETER FAILURE Attention to the care and management of peripheral intravenous (PIV) catheters has grown over the past several years. Organizations like Emergency Care Research Institute (ECRI), Association for Vascular Access (AVA) and Infusion Nurses Society (INS) have raised awareness about vascular access complications, failure rates and the need for better clinical education. They also serve to educate consumers and improve their understanding about the risk these devices pose. 3-6 Helm, Steere, Jones, and others have contributed to the body of knowledge about PIV failure, along with the human and economic impact. 7-12 By contrast, fewer studies exist about arterial catheters (AC), their associated complications, and failure rates. Arterial catheters, however, are known to contribute to bloodstream infections (BSI) and also fail in the same manner other vascular access devices do. 13, 14 In fact, Timsit et al., report that AC BSI is similar to that observed with central venous catheters (CVC) prompting the call to employ similar prevention bundles for care and maintenance for AC’s. 15
There is growing momentum to disclose all hospital onset bacteremia (HOB) over central line associated bloodstream infection (CLABSI) as a quality indicator for public reporting in the United States (US). 16, 17 This change would certainly draw more attention to PIV and AC care and maintenance. Pay-for performance initiatives have, after all, been effective in reducing CVC CLABSI by 50% from 2008 to 2014.18 The true impact of the pandemic on CLABSI rates has yet to be appreciated, but early reporting suggests an increase in catheter-associated bacteremia. 19
INNOVATIVE TECHNOLOGY In 2019, Dr. Robert Helm provided a classic article update to “Accepted but Unacceptable: Peripheral IV Failure”. In it, he affirms that more awareness exists about the problem of PIV failure since his 2015 report, yet the problem remains unsolved.
While clinical experts and industry are striving to make improvements, the impact of trauma and contamination are fundamental components of PIV care that must be improved. The “simple transparent dressing is inadequate to fully stabilize and secure” our catheters, said Helm. Perhaps the most noteworthy statement in this article relates to the CONTINUED ON NEXT PAGE AUGUST / SEPTEMBER 2021 6
