Skin integrity preservation using a nurse-constructed silicone adhesive Foley catheter
Cathleen T Van Houten1, Carrie L Mann2, Natalya Misiti2
1Program Manager, Inpatient Wound, Ostomy, and Continence Nursing, Strong Memorial Hospital, University of Rochester Medical Center, Rochester, NY.
Aims:
Skin breakdown is common in the intensive care unit (ICU). This pilot evaluation aimed to determine whether a nurse-constructed urinary catheter securement device using a silicone adhesive could reduce the complications of blistering and other skin breakdowns in a high-risk ICU population with Foley catheters.
Design:
A prospective, non-randomised performance improvement study using a convenience sample was carried out.
Subjects And Setting:
The study sample consisted of 29 patients with urethral Foley catheters and any degree of thigh oedema in a surgical ICU at an academic quarternary medical center.
Methods:
Patients were fitted with a standard acrylic-adhesive catheter securement device on one thigh and a nurse-constructed device on the contralateral thigh. At the beginning of each 12-hour shift, the nurse moved the Foley catheter from one securement device to the other; the nurse recorded the assessment findings at the end of the shift.
Results:
The average age of the 29 patients was 61±16 (range 20-87) years. Visible skin compromise occurred in 21% of the time with the standard acrylic securement device; an equal percentage of men and women developed skin breakdown. Oedema status was a significant factor related to skin breakdown. There was no visible damage to the skin associated with the nurse-constructed silicone-adhesive device.
Conclusions:
A silicone adhesive urinary catheter securement device causes less skin damage than one with acrylic adhesive. One-step application, pain-free and atraumatic removal, and reliable securement are essential considerations in product development.
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