Your polices on Central Venous Line Dressing Changes

[J. Baptist]

I am a pediatric oncology nurse. Recently we have been looking into what other hospitals are doing in regards to CVL dressing changes. It seems that our policy is out of date and may not be the best way to prevent infections. I'm curious to know what other hospitals are doing and maybe the basis for that practice. Right now we change the dresssing every M,W,F with 2 alcohols, 2 betadines, wait 2 minutes, clean with 1 alcohol, then put betadine oinment, gause and a tagaderm. What we are finding is that we cannot visually see the sight because of the gauze, and that by opening the dressing every other day we may be exposing the area to infection. If anyone has any information, please write back. Thanks!

[shinobicat]

Hey J,

I too am a pediatric oncology nurse. (Well, BMT more specifically). When we change PICC or Hickman dressing, we use remove the dressing, use three chlorhexadine swabs, and then apply 2x2 gauze and a dressing. We change the dressing every three days - no polysporin, no betadine ointment. Because everyone in the area except the pt. masks, and the dressing changer wears sterile gloves, I think the risk for infection is minimal. I would think, although I am not sure that opening the line is a much greater risk than changing the dressing.

Hope this helps!

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