PASV PICC line care

[IngyRN]

I have read the manufact. recomendations& have confirmed this with certified IV RN's that line care is flush/dressing change q weekly when line not in use. We recently had a pt admitted w/?PICC line infection which the RN caring for the patient was outraged and insisted the wound infection was secondary to this "negligence" as she put it. Pt was receiving line care as above in outpt chemo clinic after infusions.

I tried to explain to the RN the above, but since the hospital protocol is for flush qshift and dressing change q72 hrs she could not believe the above was acceptable care.

I was wondering what do you see or use for PICC line care in the hospitals and community. Have seen any increase in infection rates when done on weekly basis?

[Binkey, BSN]

My first thought is: Is this a pt who is immunocomprimised? If so, he or she may be more prone to infections, however, that doesn't necessarily correlate to an increased frequency of drsg changes to the PICC catheter. Each time you do a sterile drsg change, you increase the possibility of introducing more organisms, especially if strict sterile technique is not adhered to with this procedure. In our organization, sterile dressings to all catheters over 3" in length are done every 7 days and prn. If the pt's dressing is C/D and intact the 7 day interval is fine, and in some cases actually preferred.

Site infections that occur before the 10 day interval, usually are a result of poor antispesis, or questionable insertion techniques. After 10 days, the infections of a CVC or usually due to improper hub cleansing/manipulation or bacteria introduced in the delivery of medications (tubing, cap changes).

Hope this helps.

DD

I have read the manufact. recomendations& have confirmed this with certified IV RN's that line care is flush/dressing change q weekly when line not in use. We recently had a pt admitted w/?PICC line infection which the RN caring for the patient was outraged and insisted the wound infection was secondary to this "negligence" as she put it. Pt was receiving line care as above in outpt chemo clinic after infusions.

I tried to explain to the RN the above, but since the hospital protocol is for flush qshift and dressing change q72 hrs she could not believe the above was acceptable care.

I was wondering what do you see or use for PICC line care in the hospitals and community. Have seen any increase in infection rates when done on weekly basis?