Based on published intravascular infection control guidelines from the Centers for Disease Control (CDC) and Prevention, the following practice changes for intravascular therapy have been implemented effective October 16, 2000.
Tubings
A. IV tubings – change every 96 hours.
Re: tubing labels…continue to use the current 72 hour tubing
change label; however, DATE IT FOR 96 HOURS. (New labels for
the 96 hour change will be available within the next couple of
months.)
Exceptions:
1. TPN: change filter and tubing every 24 hours
2. Change tubing when changing in-line filter
3. Lipid: change every 12 hours
4. Propofol: IV solution – change every 12 hours
IV syringe – change every 6 hours
5. Male adapter plugs (aka : ‘infusion cap’, rubber ‘hep-lock
cap’, ‘needleless connector’) on central venous catheters:
change every days (document on MAR)
B. Blood (packed or whole) tubings – change every 4 hours or
4 units, whichever comes first.
NOTE: The American Association of Blood Banking states the
blood filter, if contaminated, can be a potential source for
microbial growth when exposed to room temperature for
over 4 hours.
C. Other blood products (i.e. platelets, albumin, FFP, etc) –
change tubing within 24 hours.
Solutions
A. Commercially prepared – change every 96 hours
B. Solutions prepared by Pharmacy or Nursing –
change every 24 hours
Exception: Change solution if changing tubing and/or filters.
IV Dressings
In addition to guidelines A-D below, note the following applies
to all IV dressings in which the insertion site is not visible.
• Dressings with gauze over catheter insertion site require
changing every 96 hours
• Dressings with transparent film dressing (and no gauze
over catheter insertion site) may remain in place for
duration of catheter or 7 days, whichever comes first.
• Dressing date and day of week should be noted on
A-line and central line dressings
• PRN dressing change denotes a need to change the
dressing when it is wet, non-occlusive, or soiled.
A. Peripheral IV dressing (including BWH “long line”)
– change PRN
B. Pulmonary artery/cordis dressing - may remain in place
for duration of catheter (5 days); however, change PRN
C. A-line/central line/PICC/midline/midclavicular catheter
dressings - without gauze change every 7 days and PRN;
those with gauze at the insertion site are to be changed
every 96 hours.
D. Dialysis catheter dressing – change at time of dialysis,
and PRN
IV Catheters
Peripheral IV catheters (including BWH ‘long line’)
– change catheter every 96 hours and PRN