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A SURVEY OF CLINICIANS: BRINGING TISSUE ADHESIVE TO THE NEONATAL POPULATION Lori Kaczmarek, MSN, RN, VA-BC™ | 2021 AVA Presidential Advisor Vascular Access Clinical Specialist, Adhezion Biomedical, LLC
Perhaps the most exciting recent advancement in vascular access care and technology has come in the form of glue. Glue, or tissue adhesive (TA), has been around for many years, but it was not until September 2017 when the Food and Drug Administration (FDA) approved a unique formula specifically for vascular access devices (VADs) and with no age restrictions. And in just three short years, TA has been adopted by the Infusion Nurses Society (INS) in the recently published (January 2021) Infusion Therapy Practice Standards as a standard of care for all VADs.
landed me right in the heart of a busy NICU. I was amazed by the skill and dedication NICU vascular access and bedside clinicians demonstrated as they place and maintain VADs that to me looked like a piece of thread. The babies were so tiny that I quickly appreciated the unique challenge that came with securing and dressing the VAD. Unlike adults, there is zero tolerance for line migration and a limited surface area makes securement a far greater challenge. Over the last couple of years, I have traveled and engaged with clinicians from NICU, infant, and pediatric centers across the United States (US). My interest and desire to support the most fragile babies led me to conduct a comprehensive survey with clinicians about their experiences using TA in this population. What prompted them to explore TA? How does it contribute to VAD care in the NICU? And what changes came about because of glue?
For context and disclosure, I am a consultant for Adhezion Biomedical, LLC, makers of SecurePortIV® (SPIV) TA for vascular access. Prior to my tenure with the company, I practiced as the director of a vascular access team in southeast Wisconsin. Our Photo credit: Adhezion Biomedical, LLC 25-member team shared the same The healthcare landscape has certainly changed over challenges all clinicians do securing VADs, protecting the past 10-15 years. The advent of value analysis them, and, of course, minimizing the unscheduled teams and material management require a different dressing changes and migration issues. approach to trial and implementation of new products. While I understood the process of adding I cared for primarily adult patients in my 10 years new products to the adult population, neonates with the team, so I brought no direct, hands-on and infants were a new ballgame. The unique needs insertion or maintenance experience with the of infants and pre-term babies require multiple neonatal ICU (NICU) VADs. As luck would have it, my first clinical education support assignment for TA CONTINUED ON NEXT PAGE FEBRUARY 2021 | 2
