The draft medical technologies guidance proposes to recommend the use of the 3M Tegaderm CHG IV securement dressing for catheters inserted into central veins and arteries.  Catheters are thin tubes put into the body which can be used to deliver liquids such as antibiotics or other drugs, so avoiding the need for frequent needle injections.

Tegaderm CHG dressing is a sterile transparent semipermeable polyurethane adhesive dressing, with an integrated gel pad containing the antibacterial agent chlorhexidine gluconate (which is a widely used antiseptic and disinfectant). The draft guidance says that the Tegaderm CHG dressing should be considered for use in critically ill patients who need a central venous or arterial catheter in intensive care or high dependency units.

The device manufacturer claims that the benefits of the Tegaderm CHG dressing include a 60% reduction in the incidence of catheter-related bloodstream infection in critical care patients with intravascular catheters, and reduced risk of death from this type of infection.

Professor Carole Longson MBE, director of the NICE centre for health technology evaluation, said: “Using catheters in providing treatment or monitoring is a common procedure, and it’s important that they can be held in place securely whilst minimising infection risk to the patient.  This draft guidance, developed by the independent Medical Technologies Advisory Committee, proposes recommending the use of the 3M Tegaderm CHG IV securement dressing for catheters inserted into central veins and arteries.   The draft guidance notes that this transparent technology enables the catheter insertion site to be seen clearly, and also provides antiseptic coverage. 

“Bloodstream infections linked to central venous catheters increase patient illness, and increase costs for intensive care units. For hospitals and units which have a moderate rate of baseline catheter-related bloodstream infection, this technology could save an estimated £73 per patient instead of using a standard transparent semipermeable dressing.  For hospitals and units with very low rates of infection, they are likely to incur the cost of the dressing. We welcome comments on the draft guidance during this consultation.”

More information on the medical technology draft guidance consultation for the 3M Tegaderm CHG dressing is available at: http://www.nice.org.uk/guidance/indevelopment/GID-MT239 . The consultation closes on April 17. 

ENDS

For more information call Dr Tonya Gillis at the NICE press office on 0300 323 0142, or out of hours on 07775 583 813.

Notes to Editors

About the NICE draft guidance

1. The draft medical technologies guidance, “The 3M Tegaderm CHG IV securement dressing”, is available at http://www.nice.org.uk/guidance/indevelopment/GID-MT239 from 18 March 2015.

2. The draft guidance recommendations are:

a) The case for adopting the 3M Tegaderm CHG IV securement dressing for central venous and arterial catheter insertion sites is supported by the evidence. This technology allows observation and provides antiseptic coverage of the catheter insertion site, reducing catheter related bloodstream infections and local site infections compared with semipermeable transparent (standard) dressings. It can be used with existing care bundles.

b) The 3M Tegaderm CHG IV securement dressing should be considered for use in critically ill patients who need a central venous or arterial catheter in intensive care or high dependency units.

c) The estimated cost saving from using a 3M Tegaderm CHG IV securement dressing (Tegaderm CHG) instead of a standard transparent semipermeable dressing is £73 per patient. These estimates are based on a baseline catheter-related bloodstream infection rate of 1.48 per 1000 catheter days. Tegaderm CHG is estimated to be cost neutral when the baseline catheter-related bloodstream infection rate is 0.24 per 1000 catheter days, and cost incurring when the baseline rate falls below that figure. Estimates of the benefiting population, vary from around 88,000 to 226,000 depending on whether adult ICU episodes longer than 48 hours requiring a central venous catheter, or all adult ICU episodes requiring a central venous catheter, are used. Based on these estimates, if the use of Tegaderm CHG became standard practice, it has the potential to save the English NHS between £6.2 million and £16.5 million each year, assuming the baseline catheter-related bloodstream infection rate is 1.48 per 1000 catheter days.

3. A moderate rate of baseline catheter-related bloodstream infection is about 1.48 per catheter days, and a low rate is 0.24 per 1000 catheter days.

4. The 3MTegaderm CHG IV securement dressing is manufactured by 3M, ‘Tegaderm CHG’.

5. The Tegaderm CHG dressing is used to secure percutaneous devices and to cover and protect central venous and arterial catheter insertion sites. It aims to provide an effective barrier against external contamination. The dressing and the integrated gel pad are transparent to allow observation of the catheter insertion site. The integrated gel pad is designed to reduce skin and catheter colonisation to suppress regrowth of microorganisms commonly related to catheter-related bloodstream infections (CRBSI). The dressing is available in 4 different sizes but the most common size, accounting for 85% of sales, is 8.5 cm by 11.5 cm.

6. The cost of the 3M Tegaderm CHG IV securement dressing stated in the sponsor’s submission was £6.21. This cost was based on the list price of the Tegaderm CHG 1657R (8.5 cm×11.5 cm) dressing. This cost includes VAT.

About the Medical Technologies Evaluation Programme

7. The focus of Medical Technologies Evaluation Programme is specifically on the evaluation of innovative medical technologies, including devices and diagnostics. The types of products which might be included are medical devices that deliver treatment such as those implanted during surgical procedures, technologies that give greater independence to patients, and diagnostic devices or tests used to detect or monitor medical conditions. The independent Medical Technology Advisory Committee has two core remits: selecting medical technologies for evaluation by NICE guidance programmes and also developing medical technologies guidance itself. The guidance applies to the NHS in England, and is not mandatory. More information is available at http://www.nice.org.uk/MT.

About the Medical Technologies Evaluation Programme

1. The focus of Medical Technologies Evaluation Programme is specifically on the evaluation of innovative medical technologies, including devices and diagnostics. The types of products which might be included are medical devices that deliver treatment such as those implanted during surgical procedures, technologies that give greater independence to patients, and diagnostic devices or tests used to detect or monitor medical conditions. The independent Medical Technology Advisory Committee has two core remits: selecting medical technologies for evaluation by NICE guidance programmes and also developing medical technologies guidance itself. The guidance applies to the NHS in England, and is not mandatory.

More information is available at http://www.nice.org.uk/MT.