central line changes

IVRUS, BSN, RN · Dec 12, 2014

TPN tubing should be changed with each new bag, or at least q 24hours, with all populations. Many institutions will used Chloroprep to cleanse the IV site at periodic intervals, and some limit Chloroprep's use to those over two years of age. What does your policy say?

Bgwalth · Dec 12, 2014

That is our current policy, but in accordance with the CDC guidelines we are going to every 96 hour tubing changes. everyday a new bag of TPN and lipids are hung. We use chloraprep for any neonates over 1000g.

NicuGal, MSN, RN · Dec 12, 2014

Ours is every 96 hours, IL is changed every 24. Dressing are weekly and we use chloroprep on intact skin and over 1000gm.

denicu · Dec 13, 2014

How often do you change TPN tubing on your central lines and do you use one nursr or two for the procedure? Do you use chloraprep or alcohol?

I am a traveler so I have seen it all but this is a first for me-all tubings including TPN are changed q 72hrs. Doesnt matter if its a central line-still every 72hrs. However IL is changed q 24hrs and only runs for 10hrs then another syringe is hung for another 10hrs for a total of 20 hrs. Here only chloraprep is used. No alcohol. Most places its a 2 man procedure but I have been places where its a 1 man procedure where 2 sets of gloves are used and lots of sterile cloth. You just have to go with your hospital policy and as a traveler your motto should be "when in Rome-do as the Romans do"

katierobin23 · Dec 15, 2014

TPN and lipids (and tubing) are changed every 24 hours, clear fluids are also changed every 24 hours, but the tubing is good for 96 hours, unless the baby is on a drip in which case the tubing is changed with the fluid.

One person does it, unless we want to go really quickly (unstable baby on pressors, for example), then a second nurse will help.

We assemble lines on sterile towels with sterile gloves and then clean the port with chloroprep before hanging the new lines.

littlepeopleRNICU · Dec 30, 2014

We have recently had a few changes in our policy. Up until now, tubing and microclave changes were Q72hr, with the exception of IL tubing being changed daily. All hyperal or fluids with anything added to them also changed daily. If a baby had solely clear fluids running(like D10W with no additives), that fluid bag was good until it ran out or 72 hours were up from the spike time. Now, all tubing, fluids, and microclaves are changed daily. For dressings, we change once a week and PRN. Biopatches and chlorhexidine are used on babies greater than or equal to 28 weeks.

karnicurnc, MSN, APRN, CNS · Jan 1, 2015

Before we implemented a very comprehensive IV tubing change policy our CLABSI rate was quite high, higher than the national average. Since then, 6 years later, our CLABSI rate has fallen to less that 1 per year. Our policy includes the following:

All IV tubing is changed every 24 hours, with the exception of IL tubing, which is changed every 12. It is a one-person operation with sterile gloves, gown, field, and tubing, hat and mask. Chloroprep is used to clean the hub before changing to new "clean" fluids, and before administration of meds through a dedicated medline. Central line dressings are changed every 14 days or as needed. Chloroprep is used on all infants. Alcohol wipes can be used to start a PIV. We are currently trialing a closed-system for our arterial lines to decease the number of times the line is broken into for blood draws.

rnkaytee · Jan 6, 2015

It's so interesting that units have such varied practices! The bag/lipid syringe is changed every 24 hours but the actual tubing is changed every 72 hours - I was under the impression that there was pretty good evidence that the longer intervals decreased CLABSI rates and we changed from 24 hours to 72 maybe 8 years ago? Also the hub is only cleaned with alcohol - the chlorhexadine can break the tubing down.