ICU Question about central line infection control

[Benj2610]

Doing a PICO project and it would be helpful to know from any ICU RN's or anyone that may have an answer...

Do ICU RN's do dressing changes on IJ's / central lines?

and

Are Chlorhexidine baths standard practice in the ICU (for IJ's/Central lines)

- Thanks

[BSN16]

When inserting central lines we dont give chlorhexiidine baths. Our insertion kit comes with a few chloro-preps that are used in the sterile procedure. Also like others have said it is standard to change them every 7 days or when needed.

[Kuriin, BSN, RN]

Our hospital, the floor nurses nor ICU nurses change the PICC dressings. It is for the PICC nurses only.

[Joanie49]

At our hospital we have a vascular access team (VAT) who are suppose to do our dsg changes/care. Long story made short it NEVER GETS DONE by them........like ever. I kind of wonder what they do during the day sometimes.........Anyway's floor nurses always end up doing all the care for the central lines/ IJ's/ PICC's. We always use chlorhexidine to cleanse.. Hope this helps!

[Nurse_Lily, RN]

In our mainly Neuro ICU, we definitely have patients who stay long. RN's will do the dressing change on triple lumen IJs and Femorals q7 days or PRN (when visibly soiled or no longer intact). We also stay on top of IV bag changes and IV tubing changes. We've also implemented the use of Curo alcohol caps for all lines (central and peripheral) and IV tubing being used by a patient in the ICU.

Daily CHG baths with wipes are also part of our protocol. CLABSI free for 6+ years.

[dy3p]

I work in a cardiac ICU and we do central line dressing changes every 7 days or as needed. Chlorhexidine bath is necessary for all the patients having central lines. And in our unit, every patient has them unless they're for transfer to regular wards. So far, we've managed to have 0% CLABSI and CAUTI for the past 5 years.

[MikeyT-c-IV]

Once upon a time our vascular access team did all routine dressing changes. The FTE's were reduced and that service went away. Now bedside nursing changes all dressings. Per our policy we use a biopatch which allows us to go 7 days between dressing changes unless the dressing obviously needs to be changed. It is also in our policy to use the CHG wipes daily.

[Smalltimore]

In our ICU all patients get a chg bath unless contraindicated. Bedside RNs change all central line dressings except for PICCs. Our vascular access RNs place and manage those lines.

[Greenclip]

We change CVC dressings q 7 days or earlier if soiled. Every ICU patient gets a daily CHG bath. We use the CHG foaming solution, not wipes.

[Oh'Ello, BSN, RN]

RN's change central line dressings where I work. A select group who've received training change PICC's (simply because of the displacement risk). I'm not sure who else is expected to change them.... Physicians? LOL

[ClauICURN]

In my ICU we do chlorhexidine baths daily am for everybody, and change central line/mid line dressings q7 days or PRN.

[iluvivt, BSN, RN]

Its critical that the needleless connectors get changed at least every 7 days but no more frequently than every 72 hours unless compromised. Approximately half of CVAD related bloodstream infections from long term CVADs are introduced from the needleless connectors.There are intraluminal and extraluminal potential sources .The hub should be scrubbed with alcohol after the cap is removed and allowed to air dry before the new NC is applied.I often see nurses skip this step,both parts of it not realizing its importance.

[Nurse_JackieVA, BSN, RN]

When I worked at a teaching facility in California - RNs did the drsg changes and EVERY pt got a CHG bath. I recently worked in a Step-down in Virginia - RNs do the drsg changes and CHG baths were only for pt's with lines (not PIVs).