Tubular dressing retainer: retention without restriction
- Collection:
- Health Policy and Services Research
- Series Title(s):
- Pennsylvania patient safety advisory
- Contributor(s):
- Pennsylvania. Patient Safety Authority. ECRI (Organization) Institute for Safe Medication Practices.
- Publication:
- [Harrisburg, Pa.] : Pennsylvania Patient Safety Authority, c2008
- Language(s):
- English
- Format:
- Text
- Subject(s):
- Bandages -- adverse effects Finger Injuries -- etiology Finger Injuries -- prevention & control Infarction -- etiology Infarction -- prevention & control Medical Errors -- prevention & control Vascular System Injuries -- etiology Vascular System Injuries -- prevention & control Equipment Safety Fingers -- blood supply Inservice Training Humans Pennsylvania United States
- Genre(s):
- Technical Report
- Abstract:
- Tubular dressing retainers are commonly used to apply and hold dressings, creams, and other devices in place. However, improper application of the retainer and use of incorrect size, especially on digits, has caused harm to patients. Injury can occur if the tubular dressing retainer is mistakenly used as the gauze dressing, especially if multiple layers are applied with multiple turns. Since June 2004, PA-PSRS has received two reports indicating circulatory compromise to digits with tubular dressing retainer application. Additionally, the U.S. Food and Drug Administration's Manufacturer and User Facility Device Experience (MAUDE) database revealed events of vascular complications following application of tubular retention dressings on digits including the thumb. Although a small number of cases were reported in the MAUDE and PA-PSRS databases, the events described indicated significant harm to patients, including amputation of digits. Facilities may reduce harm to patients by implementing processes to improve the safety of tubular retention dressings. An inventory of tubular dressing retainers in a facility can help target strategies to be implemented. Education for physicians, nurses, and other healthcare providers involved in the application of these dressings is essential. Patient education and instructions regarding these dressings are necessary to reduce harm.
- Copyright:
- Reproduced with permission of the copyright holder. Further use of the material is subject to CC BY-NC-DC license. (More information)
- Illustrations:
- Illustrations
- NLM Unique ID:
- 101568423 (See catalog record)
- Permanent Link:
- http://resource.nlm.nih.gov/101568423