The medical technology guidance advises using the 3M Tegaderm CHG IV securement dressing for critically ill patients who need a central venous or arterial catheter in intensive care or high dependency units. 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 evidence considered showed that the Tegaderm CHG dressing offers better protection against catheter-related bloodstream infection than sterile semipermeable transparent dressings. If using the Tegaderm CHG dressing becomes standard practice, the reduction in infections has the potential to save the NHS in England an estimated £4million to £10million each year.
Professor Carole Longson MBE, director of the NICE centre for health technology evaluation, said: “We’re pleased to publish this new medical technology guidance on a device which could help the NHS save up to £10million each year by reducing infections linked to catheter use. Catheters are commonly used in providing treatment or monitoring, so it’s important that they can be held in place securely whilst minimising infection risk to the patient. This guidance, developed by the independent Medical Technologies Advisory Committee, proposes recommending the use of 3M Tegaderm CHG IV securement dressings for catheters inserted into central veins and arteries. The 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. This saving is not possible if hospitals and units already have very low rates of infection. So hospitals should consider their infection rates to help them to decide if investing in the dressing is right for them. The use of 3M Tegaderm CHG could have a significant impact on catheter-related infections if its use becomes standard practice in hospitals that are not able to achieve very low infection rates by other means.”
The medical technology guidance for the 3M Tegaderm CHG dressing is available at: http://www.nice.org.uk/guidance/mtg25 .
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 guidance
1. The medical technology guidance, “The 3M Tegaderm CHG IV securement dressing for central venous and arterial catheter insertion sites”, is available at http://www.nice.org.uk/guidance/mtg25 from 22 July 2015.
2. The 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. It reduces 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 adults 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. This estimate is 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 population for Tegaderm CHG based on adult intensive care episodes needing a central venous or arterial catheter vary from around 88,000 to 226,000 depending on whether episodes longer than 48 hours, or all episodes, are used. Based on these estimates, if the use of Tegaderm CHG became standard practice, it has the potential to save the NHS in England between £4.2 million and £10.8 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. Tegaderm is estimated to be suitable for between 88,000 to 226,000 patients each year in England (in intensive care or high dependency units.)
5. The 3MTegaderm CHG IV securement dressing is manufactured by 3M, ‘Tegaderm CHG’.
6. 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.
7. 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
8. 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.
The National Institute for Health and Care Excellence (NICE) is the independent body responsible for driving improvement and excellence in the health and social care system. We develop guidance, standards and information on high-quality health and social care. We also advise on ways to promote healthy living and prevent ill health.
Our aim is to help practitioners deliver the best possible care and give people the most effective treatments, which are based on the most up-to-date evidence and provide value for money, in order to reduce inequalities and variation.
Our products and resources are produced for the NHS, local authorities, care providers, charities, and anyone who has a responsibility for commissioning or providing healthcare, public health or social care services.