Do you put tubbing and connections from central lines outside the incubator?

[sofiam]

Hi!

I know that some units put their tubbing and connections from central lines outside the incubator, because of the humidity and warm environment inside that may help bacterias coloninzing them...

How do you do in your unit?

Do you have any cientific evidence that support this, based on the reduction of infection associated to central lines?

Just one more thing: do you protect your connections with any steril paper or fabric?

Big thank you

[Imafloat, BSN, RN]

Prevention of central line infections is a huge deal where I work. We have gone over a year without one. We put the connectors inside the bed. We change the tubing every 3 days on HAL and other fluids. For lipids, the tubing and interlink cannula are changed daily, we wrap a piece of tape around that connection so we know which one it is. We change male adapters every 6 days. We wipe all connections with an alcohol wipe for 30 seconds before unconnecting them.

[SteveNNP, MSN, NP]

Tubing and connections remain inside the bed, we change all tubing q96 that's running over 10cc/hr except for lipids, which gets changed q24 down to the port. Anything running

All our line changes are done on a sterile field with a mask and sterile gloves. We recreate another field around the PICC connector before swabbing and connecting the new fluids.

[Preemienurse23]

We change our HAF daily, but we also have lipids in ours, we don't run it separate. Our PICC lines are supposed to be a sterile change, which doesn't make sense to me because we connect and prime everything "clean," wear a hat and mask, and then don sterile gloves just for the switch. We clean the old connection with alcohol, and then swap the female part of the PICC just before we connect the line. PIV's are not required to be sterile, just uber clean.

[RainDreamer, BSN, RN]

We keep the tubing connections in the bed.

We change all deep lines sterilely. Any time we break into a deep line we have to be sterile.

[lovemyjob]

I understand many places do change tubing/disconest tubing/enter ports using sterile gloes and mask and sterile feild, but I am not really understanding why. If the outside of the tubing is not sterile and you touch it with sterile gloves, then your sterile field is contaminated. Can someone explain the benefits of using the sterile field?

TIA

[RainDreamer, BSN, RN]

We swab the ports/tubing around the connection before we disconnect and re-attach.

We've been doing the sterile line changes for the past year and a half and our infection rates have gone down tremendously. So, it's worked great for us, even though it's a lot more time consuming .... in the long run it keeps our kiddos safer.

[LilPeanut, MSN, RN, NP]

all lines, except standard formulations (that pharm hasn't added anything to) or meds (like morphine or versed) get changed q24.

Preparing lines for change is a sterile procedure. Connecting all the lines to each other etc. Then we are clean for switching it at the port. All hubs are cleaned with 2 alcohols, wait 30 secs, then access.

[SteveNNP, MSN, NP]

I understand many places do change tubing/disconest tubing/enter ports using sterile gloes and mask and sterile feild, but I am not really understanding why. If the outside of the tubing is not sterile and you touch it with sterile gloves, then your sterile field is contaminated. Can someone explain the benefits of using the sterile field?

TIA

You're right... once you touch the bag to spike, it, you've gone from a sterile to a "clean" field.

However, we drop the tubing onto our sterile field first, connect all ports, THEN spike the bag and run it. So you're not really touching anything except clamps. You ARE able to connect tubing to triple ports, etc while sterile before spiking the bag.

Hope this helps!

Stevern21

[RainDreamer, BSN, RN]

You're right... once you touch the bag to spike, it, you've gone from a sterile to a "clean" field.

However, we drop the tubing onto our sterile field first, connect all ports, THEN spike the bag and run it. So you're not really touching anything except clamps. You ARE able to connect tubing to triple ports, etc while sterile before spiking the bag.

Hope this helps!

Stevern21

That's what we do.

Has there been a decrease in your infection rates too?

[Imafloat, BSN, RN]

You're right... once you touch the bag to spike, it, you've gone from a sterile to a "clean" field.

However, we drop the tubing onto our sterile field first, connect all ports, THEN spike the bag and run it. So you're not really touching anything except clamps. You ARE able to connect tubing to triple ports, etc while sterile before spiking the bag.

Hope this helps!

Stevern21

OK, I had a busy day at work and am brain dead, so forgive me if I missed something. If you connect the ports then spike the bag, how do you prime your tubing?

[Mimi2RN, ASN, RN]

I'm curious, too. What kind of pumps and tubing do you use? We have bifurcated tubing for our double lumen UVC's, add to that the lipid tubing, it's a complicated set-up which we change every 24 hours but as a clean procedure.

I like the idea of 96 hours, seems that there would be less chance of contamination with fewer breaks in the system.