CVC dressing change

[drdonna]

I'm a student nurse and I'm wondering if my class instructor's practice might be out dated. (She's been an RN for more than 40 years but I don't know when she was last in a clinical setting.)

A similar question has been asked a couple of times but the threads are at leas 4 years old, so....

In your experience, when CVC dressings are changed, do you use clean gloves or sterile gloves and do you use a face mask?

CDC guidelines for evidence-based practice says you can use clean or sterile gloves and makes no mention of a mask.

My clinical instructor said masks are not used but as far as she knows, in this area, sterile gloves are used over clean.

My textbook doesn't say one way or the other.

I know policies can vary by facility, but I just want to get an idea of what's actually happening in practice.

Thanks.

[Rose_Queen, BSN, MSN, RN]

My facility's policy is mask and sterile gloves. Only allowed to be done by IV team nurses. Tactic to try to reduce CLABSI.

[AJJKRN]

My facility requires us and even the Pt if needed, to wear a mask during dressing and cap changes. We can use clean gloves to take the dressing off but everything forward (cleaning/reapplying) requires sterile gloves and technique. Do you have access to resources such as Lippincott?

[Dranger]

Any nurse can change a CVC dressing. In the ICU all of our patients have one so every nurse has done it a million times.

A mask with sterile gloves comes with the kit and yes I use the mask.

Generally we change every 7 days or when the biopatch soiled/saturated or if the dressing is breached due to wear/drainage.

[Asystole RN]

You can use clean gloves to remove the old dressing and disposable equipment like the securement device and the antimicrobial disk if you facility is using them.

The site then needs to be cleansed in a sterile fashion which means the use of sterile gloves and mask.

The CDC may not be the best resource on these kinds of things becuase they slowly update their recommendations and base them off of even older studies. The golden standard is to follow the recommendations of professional organizations that set the standards of practice.

Once I land and get home I will post the relevant INS Standards.

For those wondering about my CDC statement, handwashing is only a level 1B recommendation lol, take it with a grain of salt.

[ArmaniX, MSN, APRN]

We use sterile gloves, mask, hair cap and a yellow isolation gown. It's literally like performing surgery.

[MunoRN, RN]

You can use clean gloves to remove the old dressing and disposable equipment like the securement device and the antimicrobial disk if you facility is using them.

The site then needs to be cleansed in a sterile fashion which means the use of sterile gloves and mask.

The CDC may not be the best resource on these kinds of things becuase they slowly update their recommendations and base them off of even older studies. The golden standard is to follow the recommendations of professional organizations that set the standards of practice.

Once I land and get home I will post the relevant INS Standards.

For those wondering about my CDC statement, handwashing is only a level 1B recommendation lol, take it with a grain of salt.

I don't know where this keeps coming from, but professional practice organizations do not "set the standard of practice". Universal or near universal acceptance and implementation of practices is what defines the "standard of practice". It's pretty common for practice recommendations to reach the level of standard of practice, but just because an organization recommends something does not make it a legal standard of practice.

[Karou]

What is your facilities policy? Ours has a detailed step by step description of how a central line dressing needs to be changed. It does include sterile gloves and a mask.

At another facility they also used sterile gloves and mask, with the addition of an isolation gown. Dedicated IV nurses did all central line dressing changes.

[KelRN215, BSN, RN]

I have honestly never heard of doing it without a mask and with clean gloves. You can use clean gloves to remove the old dressing but cleaning and applying the new one are done with sterile technique and a mask is worn throughout. That's why there are sterile gloves and masks in the CVL dressing change kits.

[BrnEyedGirl, BSN, MSN, RN, APRN]

As long as I can remember (>20 yrs) our policy is sterile gloves and mask for me and the pt. Our kits contain 2 masks and sterile gloves.

[sjalv]

Clean gloves to remove. Mask, sterile gloves/technique, and CHG prep around site when applying new dressing.

[~PedsRN~, BSN, RN]

Yep, like other posters - we use clean gloves to remove the dirty dressing, then sterile to clean and reapply the new one. Everyone in the room is masked, including the patient.