I was wondering what everyone did when they changed their TPN/IL. How often do you change the tubings, how do you change the tubings, etc.
We:
1. Change TPN q24 and IL q12.
2. Lines are hung "cleanly" as opposed to sterilly. Honestly I think they are changed dirty because we don't use any sort of sterile field, just the packaging the tubings come in, and we change them and then walk across the room to hang them, rather than just hang them at the bedside.
3. We use a system that has a trifuse that directly connects to the PICC/UVC/PIV, etc. and then the IL tubing and TPN tubing connect to the trifuse. We change the tubings q24, but the trifuse q72. We are thinking we should change everything q24.
Hi there everyone....I was doing a history search for info about this same topic and I was hoping I could get some more current responses.
How often are you changing you IV tubings and are you doing it under sterile conditions??
Also, if you respond, would please include your NICU level and general size?? Any affiliation with VON??
Thanks in advance....I am hoping to get some usable information to take back to my unit. We seem to be having a lot of debate about 24 hour vs. 72 hour changes. (We are a 25 bed level III with no affiliation with VON.)
We change TPN/IL q24, clear fluids q72. If it's a PIV we do it with clean gloves. If it's a picc/central line we don hat/mask/sterile gloves. Of course, it's not actual sterile tecnique. More like very clean.
TPN and LIpids is q24. Our Picc lines have a triport with posi-flow adapters at each port- those are changed every 72h.
Clear fluids is q72. We have a lot of double lumen Piccs, so usually the med line is with the 2nd lumen that's just running d5W w/hep. If your med line is with the TPN/Lipids then it gets changed q24.
We are supposed to use sterile technique, but that is impossible because you are touching your tpn bag or your syringes. What I do to remain as sterile as possible is I connect all of my tubing before I touch anything else. Everyone else does it different. I've seen them be sterile and grab their syringe and prime tubing, then hook it into the triple port. I prefer to connect as many things as I can while sterile, and remain extrememly clean once I've touched the TPN bag or syringes.
I'm at a level 3 NICU, 72 beds, although the highest census I've seen was 62.
From my rotations there it is q24hr for TPN and IL. Sterile technique at bedside with full scrub; drape, gloves, and mask/shield. Sterilize hub with alcohol, 10 second scrub, and air dry 25.
Being a student, we had to recite this every time we walked by a pod before they would let us anywhere close...I am pretty sure I have the protocol down pat at this point.
With our tubing, we change TPN and clear fluids Q96. The TPN bag gets changed daily, but clear fluids can stay up for 96 hours, UNLESS they are changed by pharmacy. If they have adds, the bag needs to be changed daily. Lipid bags and tubing changed daily. Drip syringes and tubing daily. If fluids are mixed by pharmacy, tubing changed Q96 and bag changed daily.
All bag and tubing changes are done at the bedside (why wouldn't you??) and clean, just with gloves. Our infection rates are pretty low, too.
shonda13
6 Posts
Hi there everyone....I was doing a history search for info about this same topic and I was hoping I could get some more current responses.
How often are you changing you IV tubings and are you doing it under sterile conditions??
Also, if you respond, would please include your NICU level and general size?? Any affiliation with VON??
Thanks in advance....I am hoping to get some usable information to take back to my unit. We seem to be having a lot of debate about 24 hour vs. 72 hour changes. (We are a 25 bed level III with no affiliation with VON.)