Central line dressing question

[schnookimz]

My charge nurse has been encouraging me to change central line dressings once a day or once every two days--even when the dressing is clean, dry, and intact.

Facility policy says it needs to be changed once every 7 days as long as it's clean, dry and intact.

Obviously we can change it more frequently as needed.

Now my question: is it better to apply a clean dressing often (even when the old dressing is clean and only 24-48 hours old) or is it best to leave a clean dressing alone so as not to continuously reopen the dressing and possibly introduce new germs to the site?

[loriangel14, RN]

I would agree that frequent dressing changes will increase opportunities for infection .

[AGACNPTX]

Better to leave it

[Here.I.Stand, BSN, RN]

What is your facility's policy? Ours are changed 24hrs post insertion, then q 7 days and prn. Admittedly I haven't read much research on this topic myself, but I too would worry that removing an intact dressing is removing the barrier to new microbes. I've never heard of changing a CVC dressing daily unless it's peeling off that often (for example, w/ diaphoretic pts.) Find your policy. If your policy doesn't say change q day, then you can point that out to your charge RN.

[KelRN215, BSN, RN]

Central line dressings are changed q 7 days or when soiled/non-occlusive. The more you mess with the line, the higher the risk of infection. What is the charge's rationale?

[blondy2061h, MSN, RN]

Definitely leave it! Every time you open that area you're exposing it, risking infection, skin tears, tape burns, and contamination. Bad plan! My facility actually extended the policy from q4d changes to q7d and noted decreased CLABSI.

[schnookimz]

thank you all!!! My instinct was to leave it be--glad to hear that confirmed!

[K+MgSO4, BSN]

Find your hospital policy and show it to her.

[VANurse2010]

Follow your hospital policy, because what she's suggesting is just gross and a major risk for infection.

[toomuchbaloney]

Follow policy. You are hired to use your nursing judgement and critical thought not to blindly follow the orders of another professional

[schnookimz]

Follow policy. You are hired to use your nursing judgement and critical thought not to blindly follow the orders of another professional

Well I obviously wasn't blindly following her since I asked opinions of others. But thank you.

[classicdame, MSN, EdD]

I hope your facility policy is based on the Infusion Nurses society guidelines (or another, equal authority). See their website at www.INS1.org