CVC dressings and line changes - still aseptic technique

[chani]

I was asked the comment on something the other day which initially made me go YUCK and then I thought am I just being precious and not keeping up with the times.

I was asked whether sterile gloves were still the recommendation for CVC line and dressing changes.

This person was reviewing a guideline where no-touch technique plus use of alcohol handrub was advocated.

The most recent US (CDC) and European (EPIC2) still advocate aseptic technique, and ofcourse alcohol handrubs do not kill c diff, so it would seem I am probably correct. However as I like to check I would like to hear from the general members.

[WindwardOahuRN, RN]

We recently switched from aseptic to strict sterile technique. Not a terribly big deal, just a switch to sterile gloves. We were doing the "no-touch" technique for years. And we always put a mask on non-vented patients in addition to wearing one ourselves. I honestly can't remember the last time I saw a confirmed case of line sepsis but the switch to sterile technique seems to be the latest trend. We culture our line tips if we suspect sepsis and they always come back clean. The fact that we use CVC's that have an anti-bacterial coating may have a lot to do with that.

Personally I think line sites are more likely to get contaminated from loose dressings and contamination-likely sites (fem lines) than from poor dressing change techniques but what the heck. Just go with the flow.

Years ago changing the dressing on a central line was a huge deal. Close the windows and doors, turn off the air-conditioner (really), full sterile regalia. We're talking back in the day where CVC's were only allowed in ICU's. We used to slather the site with betadine ointment, too.

Yes, I am that ancient. :)

[Zookeeper3]

oh, the betadine ointment.... lol! Now I feel like a dinosaur too:lol2:

We have central line dressing change kits that include the masks, sterile gloves, chloraprep, alcohol and dressing. We've always done sterile, with sterile gloves, just switched to the kits with chloraprep when it came out

[wanderlust99]

We do it sterile. Every place I've worked in the past 5 years as a nurse/traveler have done it sterile. My question for you guys is HOW OFTEN do you change the dressing? My new place says every 7 days, which feels too long for me. Or change if soiled. Everyone is using the biopatch now too. At my new hospital we change the caps with dsg changes. We have the dsg change kits which are nice.

I've found wiping alcohol before you hook in IV lines to be the most affective:) And not everyone does this anymore, but I've noticed a difference in infection rates at different hospitals I travel to. I know this will sound surprising, but when I first learned to become a nurse I picked up some bad habits, including not using alcohol swabs on IV line ports when connecting.

[ghillbert, MSN, NP]

Definitely strict aseptic technique as per CDC. Also have a "scrub the hub" initiative in the hospital to remind people to wipe for 15 secs when accessing ports - it is absolutely astonishing to see the number of people who disconnect, hold and reconnect lines without keeping them sterile and/or without wiping the hubs. Ugh.