Policy on IV tubing/bag change?

Nurses General Nursing

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I'm in a new unit and their policy on changing iv tubing/bags is different from where I worked. I looked up CDC guidelines (actually googled it and got sent to another site but it seems legit) and the recommendations seem little contradictory. Here's the site for anyone who is feeling motivated! :lol2:

4.5: Prevention of IV Related Infections

The basics are nothing new: change tubing q 72 hours, maintain a closed system, etc.

Then it says that Large Volume Parenterals should be used up or discontinued if not completed in 24 hours.

Large volume is not defined...is that the 4L bag of TPN (obviously) or the 50cc bag of epinephrine? What about the 250cc bag of epi?

My issue (and maybe it's just me...my previous institution changed everything: bags, tubings, stopcocks, q 72 hours except for TPN) is that if you change the bag q 24 but change the tubing q 72 aren't you breaking that closed system? If your base solution isn't dextrose, it seems that by unspiking, then respiking a new bag, you have a greater risk for introducing infection than if you kept it closed.

Any thoughts? Any other websites I can check?

Specializes in SICU, EMS, Home Health, School Nursing.
This is interesting. At a clinical site, my pt. had NS 20ml/hr KVO from a 1000 ml bag for 50 hrs. When I checked the tubing, it was tagged to be changed 9 DAYS EARLIER!!

Yikes... that is not good!

When we do NS @ KVO (20/h where I work), we use a 250 ml bag. It runs out after about 12 hours, but then you just hang another small one. It beats throwing away half a bag! Plus, it MAKES you change it. If it's dry, you have to hang another one. It's easy to look up and see that the bag is still half full and not think about changing it.

It's interesting that both hospitals I worked at before this one did the same thing and it's different from the majority of your responses. Huh.

And I'm the same way about labeling stuff...we have a new ICU staff and it drives me batty to have 6 stopcocks worth of meds going into the patient and not one of them is labeled. Gotta start training them! :)

And I'm the same way about labeling stuff...we have a new ICU staff and it drives me batty to have 6 stopcocks worth of meds going into the patient and not one of them is labeled. Gotta start training them! :)

Drives me nuts too! If I don't know when it's from, I have to change it! We don't have different colored labels for the days of the week (though the other large hospital in the area does - but when I was there, I can tell you that I NEVER saw them on the bags/tubing...maybe 20% of the stuff was dated). We just have bright pink labels that we write date, time, and initials on.

Specializes in Critical Care, Cardiothoracics, VADs.

CDC guidelines on changes:

Erratum: Vol. 51, No. RR-10

We went over this in depth a couple weeks ago. The guidelines say NO MORE FREQUENTLY than every 72° and can go longer except when certain

meds admin such as blood, lipids, TPN, etc.

There was a study done and I can't find it to save my life! Just read it too- but anyhow it was saying that they found less frequent changes actually reduced infections and includes the hardware. Was an interesting study and surprised me but every change is a risk of contamination I suppose. The study also mentioned less risk of infections with the new silver coated antibacterial lines and same for foleys.

...they found less frequent changes actually reduced infections

Makes sense, if you think about it. There's not much risk of contamination just switiching the spike from one bag to another, but every time you touch that port (the actual IV site, I mean), it's one more chance for bacteria to get in there. ...I don't know if I'm saying that right. You know what I mean? It's much more "hands on" to change the tubing and all than it is to just change the bag. I hope that makes sense! :specs:

CDC guidelines on changes:

Erratum: Vol. 51, No. RR-10

I could kiss you!!!!

Specializes in ICU, psych, corrections.

We change our IV tubing Q 96h, actual peripheral IV can stay in for 96h, TPN gets new tubing and filter Q 24h, and propofol is changed Q 12h. I guess we are one of the only facilities that wait so long in between tubing changes?

Melanie = )

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