Infection prevention Additionally, frequent manipulation of the
tape to check tube positioning can increase the risk of contaminating both the ET tube and the surrounding skin, especially if strict aseptic techniques are not followed. A survey undertaken by 3M (The Dirty Truth About Tapes 2022),1
found that 100% of tape
rolls were contaminated and of those tapes 52% of the tapes sampled contained MRSA and VRE. Their report cited the American Journal of Infection Control,2
whose research showed that
multiple facilities had no existing policies or standards of care relating to tape storage and use. 61.5% of staff members carried rolls of tape in pockets or on stethoscopes and only 42.9% of staff discarded unused tape when a patient was discharged. It is acknowledged that, until now, there
has not been any solution designed and risk assessed to secure an airway device in the theatre/ICU environment, leaving a vacuum where healthcare professional worldwide are forced to improvise by developing their own techniques and by using off-label generic materials such as tape and ties. From environmental surveys undertaken
in different Trusts, we know that the tape becomes colonised, and this tape is then used by practitioners for multiple patients. During these environment surveys around infection and the use of tapes it was also evident that there was a reluctance to swab their tape rolls to establish whether or not they carry infection. In healthcare, unwritten rules and ways of working can become deeply ingrained into the workplace culture and, if not managed effectively, can seriously endanger patient outcomes. Facial harm, infections and more serious
incidents are entirely preventable, yet the absence of national guidelines has resulted
Tape used to secure airway devices can become contaminated and has the potential to cause patient harm, highlighting the need for guidelines and training.
in an inconsistent approach to airway device securement and essentially to patient safety.
Insights from NHS Trusts: FOI requests and practitioner surveys Recent Freedom of Information (FOI) requests to NHS Foundation Trusts revealed inconsistent practices in securing airway devices. The data gathered showed significant variation in the types of products used, with many Trusts acknowledging the use of tapes and ties, or other unlicensed materials to secure airway devices. Practitioner surveys and focus groups further corroborate these findings. A significant number
of practitioners reported using makeshift solutions, citing reasons such as cost-saving measures and lack of awareness about the risks. While most practitioners recognised the importance of infection control, there was a notable gap in understanding the implications of using unlicensed products for device security. In the survey practitioners were asked: Are
you aware of the infection prevention risks when using adhesive tape to secure an airway? 56.5% of those surveyed were aware of the infection risks associated with using tapes. However, they continued to use this as a method of securing the airway device even though it is an unlicensed and unhygienic way of managing securement of the airway device. During the focus group meetings, it became evident that many of the delegates had little understanding about the infection risks associated with the use of tapes. This was generally because once the patient had left theatres or other areas where an airway device is required, they were not made aware, retrospectively, of any infection issues. The Freedom of Information requests showed only a small amount of Trusts reporting about HCAI because of using tapes that are non- sterile. The reason behind this may be similar to the discussions with delegates at the Focus Groups. Once the patient has left theatre, practitioners may not be made aware of the HCAI and, therefore, it is not reported. Surveyed healthcare workers expressed concerns about the lack of available training and resources for infection prevention, particularly in high-pressure environments such
34
www.clinicalservicesjournal.com I December 2024
Photo courtesy of Pentland Medical
nkeskin -
stock.adobe.com
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