[SteveRN21]

TPN tubing changed q72 unless the fluid has changed
A-line/UAC changed q72 including bioport
Lipids q24 regardless
Triple ports changed q72

[justjenny]

Our tubing is changed Q24 along with the bag....all new setup each time.
Jenny

[justjenny]

Originally Posted by Kimbalou

It sounds like some hospitals mix the TPN and lipids together?

Our hospital mixes TPN with lipids...but even if there are no lipids we still change out everything Q24

Jenny

[cathys01]

I've seen numerous times where a kid's triglyceride level goes too high and we will turn off the lipids for several hours and test again before turning them on...how do you handle that if the IL is mixed in the TPN?

[BittyBabyGrower]

We don't mix lipids with TPN...too many meds that aren't compatible per our pharmacy.

This is a hot spot in our unit right now. We change out everything every 24 hours right now because we piggyback our IL at the port below the filter, so the whole line is "contaminated". I think we are going into these lines way too much as it is.

[RainDreamer]

Just wondering how many of you change the lines under sterile technique?

[BittyBabyGrower]

We are changing over to totally aseptic techinque now...all central lines have to be changed with sterile attire. We weren't doing it and our sepsis rate has been high. We will use the two person method at first to see how it goes.

[PremieOne]

We change TPN and Lipids q24h as suggested by CDC. Our UAC lines get changed every 72 hours.

[RainDreamer]

Originally Posted by BittyBabyGrower

We are changing over to totally aseptic techinque now...all central lines have to be changed with sterile attire. We weren't doing it and our sepsis rate has been high. We will use the two person method at first to see how it goes.

Yep, that's what we're doing. All deep lines have to be changed under sterile technique, and we do the two person method. We've been doing it for months now and there's been a drop in our infection rates.

[ginger58]

I just looked at the CDC site and my question is, do you infuse lipids separately?

"Replace tubing used to administer blood, blood
products, or lipid emulsions (those combined
with amino acids and glucose in a 3-in-1
admixture or infused separately) within 24 hours
of initiating the infusion (158,226–229).
Category IB. If the solution contains only dextrose
and amino acids, the administration set
does not need to be replaced more frequently
than every 72 hours (226). "