EBP? new PIV tubing to new CVL a no no?

[ANB RN]

Situation:

Pt CABG/AVR/septal myoectomy POD 4 or 5. Pt on Heparin, Amiodarone pulls out PICC line at 0000. BP starts to decrease 80s/40s. You need to start Neo. PIV x 3 started- all bags/IV tubing changed. As pt's chest becomes unstable (popped a wire or two) and starts to bleed. At 0300, PA comes in to place central line.

Does your facility require you now change bags/IV tubing again after only three hours because it is a new line? One co-worker said it is a must due to CLABSI risk. (I could understand that if the hubs were not scrubbed appropriately or previous lines were old). I could not find any policy from my employer or a study that substantiates claim of increased risk.

Please tell me what your facility requires or links to any studies you might have read on the matter. Thanks

[missnurse01, MSN, RN]

From what I am trying to glean online, I think it might depend on your hosp policy. I have always learned that yes, you changed it all if you place a new line. Does it always happen in practice, no. Here is the link that I found, altho it does not exactly answer it.

http://www.cdc.gov/hicpac/pdf/guidelines/bsi-guidelines-2011.pdf

of course the ins1.org (infusion society) has the above guidelines only as purchase. If you have iv therapy at your hosp, they surely can answer this for your facility. Will be interesting to see what you find out!

[AMR21, BSN, RN]

Our hospital policy is new catheter, new bag. Always- unless dire emergency.

We also can NOT switch from peripheral to central w same bag and tubing. It is OK per policy, but uncommon to switch from central to peripheral w same bag/tubing.

We have very strict and successful bsi policies.