broviac, who change the dressing?

[kaibigan]

how often do you change the dressing for central lines, broviac?

do you have a special nurse to change it?

does anyone has a policy on this?

thanks!

[JenKatt]

The nurse changes the broviac dressing every 48 hours in our unit. We use a dressing change kit--clean with betadine, then alcohol after the betadine dries, a very small amount of benzoine if the baby's skin is mature enough and then a new tegaderm dsg. Generally 2 nurses do it. Both wear mask and sterile gloves. One is the "dirty" nurse and takes off the old dsg. The other is the sterile one. Our infection rate is pretty low.

Every 48 hours? Seems a bit much. In your smaller kids, doesn't there skin getting eaten up with all of the changes? Our central line infection rate is also pretty respectable with a 7 day turn around on dressings.

[AllyIII]

how often do you change the dressing for central lines, broviac?

do you have a special nurse to change it?

does anyone has a policy on this?

thanks!

not only do we have a policy, but a demonstration video. We change central line dressings only when they are soiled, or 7 days. I can send if neccessary.

[sparkyRN]

Every 48 hours? Seems a bit much. In your smaller kids, doesn't there skin getting eaten up with all of the changes? Our central line infection rate is also pretty respectable with a 7 day turn around on dressings.

It is our protocol and our infection rate is less than what it was when we did it every 5 days or PRN. Our use of broviacs is also minimal. A PICC is the line of choice for long term IV or antibiotic tx. These dsgs are changed PRN with 2 nurses changing them, one being trained in PICC insertions. For a short while we were supposed to change those q48h, but you can imagine the stink that the nurses raised when so many of the lines became dislodge! It's only when we can't get a PICC will the docs consider a broviac.

To answer your question, there aren't really any skin issues for our babies with broviacs because most are older and bigger babies with mature skin. On the rare occasion a broviac is placed in a baby under 1kg, we would alter the plan of care to take immature skin into consideration before changing an already secure dsg.

[KK7724]

how often do you change the dressing for central lines, broviac?

do you have a special nurse to change it?

does anyone has a policy on this?

thanks!

The PICC lines are inserted by a certified nurse (usually our charge nurse). She changes the dressings on them. The central lines are placed by physicians and are changed by the physicians or PA's! We don't touch 'em!

Also, at my first hospital, we had to measure extremity circumference on PICC lines...at my current hospital, we don't.

~Kristina, RN, BSN~

[sunnysideup09]

Our PICCs are inserted and dressings are changed by our NNPs only. The central line dressings changes are done every 7 days or before that if the site is no longer occlusive by the bedside nurse.

Christine, RNC, BSN

The PICC lines are inserted by a certified nurse (usually our charge nurse). She changes the dressings on them. The central lines are placed by physicians and are changed by the physicians or PA's! We don't touch 'em!

Also, at my first hospital, we had to measure extremity circumference on PICC lines...at my current hospital, we don't.

~Kristina, RN, BSN~