Central Line Tubing Change

[jack4408]

What is your hospital's procedure for changing IV bags and tubings for central lines?

[texas2007, BSN, RN]

One person gets sterile, one non-sterile helper to open supplies, unwrap baby, hold and put the fluids in the pump. Both wear hat/mask. Do a complete line change (tubing, triple connector, hub caps) daily.

[Imafloat, BSN, RN]

We change our bags and lipid tubing every 24 hours. We change the other tubing every 72 hours.

[jack4408]

Sterile or clean?

[iyqyqr]

Our pharmacy puts all our tubings together and spikes the bags under a laminar flow hood and then they are brought to our unit on a cart. Each nurse checks the bags with the order and runs the fluids through all lines. Then after wiping the white cap with alcohol 10 times the old fluids are removed and new ones attached. No sterile gowns or masks and gloves are optional. I know last year we had a full year without a central line infection. So far this year, I believe we've had one.

[littleneoRN]

Our pharmacy puts all our tubings together and spikes the bags under a laminar flow hood and then they are brought to our unit on a cart. Each nurse checks the bags with the order and runs the fluids through all lines. Then after wiping the white cap with alcohol 10 times the old fluids are removed and new ones attached. No sterile gowns or masks and gloves are optional. I know last year we had a full year without a central line infection. So far this year, I believe we've had one.

Gloves are optional?!?

[Imafloat, BSN, RN]

Sterile or clean?

Clean, when we change the male adaptor (every 6 days) we are sterile. We haven't had a central line infection in 2 years.

[BittyBabyGrower, MSN, RN]

Clean technique unless we are changing the end cap,then sterile. We change TPN tubing Q72, IL Q24, med tubing Q72.

[MegNeoNurse]

New fluid bags Q24H, new tubing Q72H (as long as the fluid is the same, e.g. 3.2% AA w/0.5U/mL Heparin). If it is Hyperalimentation going through the UVC, then Q24H the tubing gets changed with the new bag of TPN and syr. of Lipids comes up.

Tubing is changed in a sterile fashion. When breaking the line, sterile gloves are worn, I always put the wrapper the gloves come in under my port.

[NICURN29]

We change out TPN, IL, and any dextrose solutions Q24h, including tubing. We change out art line tubing q72h and the bags of art line fluids q24h.

For central lines, we use sterile technique, including a mask. However, we do it as a one-person job...no unsterile helper. For peripheral IVs, we use the same technique but no mask, unless the kid is under 1500 grams.

[ccavrn]

For those that use sterile technique (cap, gown, gloves and mask) or almost sterile (sterile gloves, mask) technique to change tubing, I am curious to know why you do this? Do you have any references, literature or textbooks that suggest to do it this way? I am a member of the Infusion nurses socitey and certified in infusion therapy, and never heard to do this. I have always taught clean technique for tubing changes, as the outside of the cathteter is not sterile anyway, and the tubing and anything hanging is not sterile on the outside once it is hung. As long as you wear clean gloves and throughly scrub the connection valve/cap at the end of the catheter, clean technique should be sufficient.

Thanks for sharing your references, if I need to update my technique.

[UTVOL3]

Clean, when we change the male adaptor (every 6 days) we are sterile. We haven't had a central line infection in 2 years.

Wow! This is awesome. Did you have a high rate of infection prior to this? Were there any specific changes you think helped contribute to a zero infection rate?