DuckDerm: An Improved Water Infiltration Prevention Product for Long-Term Intravenous Therapy Patients

We propose an alternative to the widely implemented intravenous (IV) shower guard solution, AnchorDry, which we have coined DuckDerm. The AnchorDry is a rigid square of plastic with an adhesive border on the outer edge. This design does not adhere to the arm during the bathing period as it cannot withstand the range of motion (ROM) patients exert, leaving the Tegaderm and IV site vulnerable to water intrusion. Significant water intrusion compromises the IV site, leaving it susceptible to infection. By interviewing seasoned clinicians, nursing faculty, students, and patient care technicians (PCTs) we ascertained ineffective shower guard fit is an issue rooted in design and material selections. We have found that nurses and PCTs are often getting creative to modify or make their own IV shower guards. After several design iterations and consultations with several University of Pittsburgh nursing faculty, we mass-manufactured our design. The DuckDerm body is composed of 1 mil polyethylene plastic, which is biocompatible and able to move with the skin, a hypoallergenic adhesive, and a foam barrier to envelop the Tegaderm. Based on this initial testing, we formulated our design specifications: (1) maintaining the patients ROM, (2) ease of use for both patients and clinicians, and (3) preventing water infiltration. We provided our manufactured design and interviewed nursing students and faculty (n=21) to address the following criteria: (1) the DuckDerm must be simple for clinicians to apply to not take away time from more essential tasks and to encourage patient self-application; (2) the DuckDerm must retain functionality without providing discomfort to the patient during use and removal. We also conducted functionality testing using our manufactured design to address the following criteria on volunteers (n=11): the DuckDerm must (1) contain all the IV components within the foam barrier, (2) not place unnecessary pressure on components to dislodge, and (3) fit securely on the patients arm. Additionally, the Duckderm must adhere to the skin while subjected to running water and movement, and the DuckDerm must be able to provide a sufficient range of motion about the antecubital space to allow for arm movements required while showering. The Duckderm outperformed the currently utilized solution in both verbal feedback and assessment by potential users (nurses and PCTs) and in functionality testing; therefore, we propose our novel design as an alternative to the currently employed AnchorDry.