Safety and efficacy of silicone tape for indwelling urinary catheter fixation in intensive care patients-A randomized clinical trial.

BACKGROUND: Critically ill patients are more vulnerable to medical adhesive-related skin injuries (MARSI), whose prevention is a constant challenge and one of the main quality indicators of nursing care. MARSI associated with indwelling urinary catheter (IUC) fixation is a relevant adverse event, mainly because of the constant involuntary traction and high skin vulnerability of the fixation site. Silicone adhesive tape has appreciable qualities for fragile skin among the range of adhesives, leading to the inference that it reduces the risk of MARSI. AIM: To compare silicone adhesive tape for IUC fixation with acrylate tape regarding its safety and efficacy. STUDY DESIGN: This was a randomized controlled trial blinded to the patients and evaluator. Data were collected from an intensive care unit (ICU) of a tertiary university hospital in Brazil. Patients with IUC and no MARSI at the fixation site were considered eligible. The omega (Ω) fixation technique was used for IUC fixation. A total of 132 participants were enrolled and divided into two research groups: 66 patients in the intervention group (silicone tape) and 66 in the control group (acrylate tape). Outcomes were the incidence of MARSI, patient outcome in the ICU and hospital and partial, total and overall spontaneous detachment of the tapes. RESULTS: The overall incidence of MARSI was 28%, with 21% in the silicone group and 35% in the acrylate group, with no statistically significant difference (p = .121), including the severity of the lesions (p = .902). However, partial (p = .003) and overall (p < .001) detachment of the tapes were more frequent in the silicone group. CONCLUSIONS: Silicone tape is no safer than acrylate tape for IUC fixation and is less adhesively effective. RELEVANCE TO CLINICAL PRACTICE: There is no evidence to support the extensive use of silicone tape in this context.

Conhecimento e prática de enfermeiros sobre cuidados aos pacientes com feridas / Conocimiento y práctica de enfermeros acerca del cuidado de los pacientes con heridas / Knowledge and practice of nurses about care for patients with wounds

Objective: identifying the knowledge, practice and nurses information sources about the care of patients with wounds. Method: a cross-sectional, descriptive and exploratory study performed in a university hospital in July 2010. The data were collected through an adapted questionnaire. The study included 35 nurses assigned to different sectors of work. The data was submitted to descriptive and analytical statistical treatment. Results: considering the overall results, the nurses had an average of 69.4% of hits (sd = 13.5%). The nurses that have cited utilizing sometimes some sources of information had a higher percentage of hits. Conclusion: it was concluded that nurses had insufficient knowledge in some areas on the subject. There is need to update professionals' knowledge on advances of the current evidences that base wound care, in order to guide, with the context studied, the planning of strategies to implement the best evidences available.

Objetivo: identificar o conhecimento, prática e fontes de informações de enfermeiros sobre o cuidado de pacientes com feridas. Método: estudo transversal, descritivo-exploratório, realizado em um hospital universitário em julho de 2010. Os dados foram coletados por meio de um questionário adaptado. Participaram deste estudo 35 enfermeiros distribuídos em diferentes setores de trabalho. Os dados sofreram tratamento estatístico descritivo e analítico. Resultados: considerando os resultados globais, os enfermeiros obtiveram, em média, 69,4% de acertos (dp= 13,5%). Os enfermeiros que citaram utilizar às vezes algumas fontes de informações tiveram maior porcentagem de acertos. Conclusão: conclui-se que os enfermeiros apresentaram conhecimento insuficiente em algumas áreas referentes ao tema. Destaca-se a necessidade da atualização dos profissionais quanto aos avanços das evidências atuais que embasam o cuidado de feridas, a fim de nortear, no contexto estudado, o planejamento de estratégias para a implementação das melhores evidências disponíveis.

Objetivo: identificar el conocimiento, la práctica y las fuentes de información de los enfermeros, sobre el cuidado con las heridas. Método: estudio transversal, descriptivo y exploratorio realizado en un hospital universitario en julio de 2010. Los datos fueron recolectados a través de un cuestionario adaptado. Participaron en el estudio 35 enfermeros asignados a diferentes sectores de trabajo. Los datos se sometieron a tratamiento estadístico descriptivo y analítico. Resultados: teniendo en cuenta los resultados globales, los enfermeros obtuvieron, en promedio, el 69,4% de respuestas correctas (de = 13,5%). Los enfermeros que informaron el uso, a veces algunas fuentes de información tuvieron el mayor porcentaje de respuestas correctas. Conclusión: se concluye que los enfermeros tenían un conocimiento insuficiente en algunas áreas acerca del tema. Se destaca la necesidad de actualizar a los profesionales sobre los avances de las evidencias actuales que sustentan el cuidado de las heridas, con el fin de orientar, en el contexto estudiado, la planificación de estrategias para la implementación de las mejores evidencias disponibles.