How often are your line changes?

[rnkaytee]

Many years ago we switched from every 48 hours to every 72 on all tubing changes (you name it, TPN, lipids, PIV or central - they all get changed every 72). I'm reading some information about possibly every 96 hours - does anyone do this or something similar?

[cardiacfreak, ADN]

Yehp, just changed the policy last month. Was every 72 and now every 96 hours.

[NICU Guy, BSN, RN]

96 hours for TPN and clear continuous fluids. 24 hours for med line and Lipid line. We use Curos caps on all ports.

[rnkaytee]

Was it based on the 2016 Infusion Nurses recommendations?

[BittyBabyGrower, MSN, RN]

96 hours for IVF, TPN, med lines, art lines and a couple of drips. 24 hours for lipids, and a handful of drips. Curocaps on all ports.

[nursemcsleepy, BSN, RN]

96 hours for most, 24 hours for lipids and amiodorone

[NotReady4PrimeTime, RN]

When we made the move to standard concentrations (which aren't actually standard anything, but that's a rant for another thread), we also were given new direction for line changes. The tubing itself can hang for 96 hours, with the exception of propofol, lipids, amiodarone, epoprostenol, prostin and something else that escapes me at the moment. But the rules for the actual infusions are quite confusing and wasteful. If the infusion was prepared commercially, it can hang for 96 hours. If it was prepared in the pharmacy under the hood (as if we have access to that information), it can hang for 72 hours, unless otherwise labeled. If it was mixed in pharmacy but not under a hood, it's 48 hours and everything we mix on the unit is 24 hours. Yes, I'm going to interrupt my norepinephrine infusion that's running at 0.15 mcg/kg/min and change out a syringe because it was mixed yesterday and has somehow become contaminated. Yes, sure, I'll throw away the 500 mL bags of D10W and NS I mixed heparin into yesterday while preparing for this admission and mix some more... because it has somehow become contaminated. Sure, I'll throw out $800 worth of bivalirudin that my patient with the ventricular assist device is getting to keep from clotting the circuit and mix some more... when there's enough in the syringe to run for another full day. But you know, whoever mixed it might have oh, maybe dragged the syringe tip through some mud before connecting the tubing. Please tell me how the risk of contamination is decreased by increasing the frequency of breaking a closed system. We won't even talk about the risk to the patient from interrupting their life-sustaining infusions and those that are driving them.

Another practice change that came with this standard concentration move is that we're to mix up 50 mL of whatever it is, then transfer a 24 hour supply into a smaller syringe then discard the remainder. We're told not to mix up the volume we'll need for that 24 hours, because "the risk of error is too high". The math is the same whether I need 1 mL or a million mL, but you know, we must have a standard volume... Sorry for the verbal diarrhea. It's a sore spot.

[rnkaytee]

The reason I ask is because the newest Infusion Care recs. seem to be saying 96 hours, except if containing lipids. We y-in our lipids closest to the baby so I guess technically a small amt. of tubing "contains lipids." So, some of my colleagues are reading that as "change the entire thing every 24 hours" which seems counterintuitive to limiting number of break-ins.

[KKEGS, MSN, RN]

We change TPN and lipids every 24 hours. All other fluids we change every 96 hours.

[essT]

We change everything daily. Central, peripheral, clears, TPN, critical drips, you name it...

[bcandygurl]

Same here. " We change TPN and lipids every 24 hours. All other fluids we change every 96 hours.

"

[NYbabyRN, BSN, RN]

We change TPN, lipids, med line and intermittent drips every 24 hrs. Continuous fluids every 96 hrs.