I.V Tubing Change

[NGYSUN, BSN, MSN, RN]

Hi everyone,

I have a quick question. How often should the secondary tubing be changed when a pt is getting same medication.

For example, if a pt is getting Vanc Q12hrs and a new primary and secondary tubing was set up yesterday morning. Will the secondary tubing still be appropriate to be used for today's medication assuming the empty vanc bag was still attached to the primary tube? And maintenance fluid like NS is still infusing.

I know we do label our primary tubing to know when to change it next.

Thanks for your response.

[AJJKRN]

My facility just recently lengthened the time frame from 72 hours to 96 for continuous IVF. It is 24 hours if intermittent.

[MunoRN, RN]

Once the secondary tubing is connected to the primary it should be considered the same set and should be changed together; no more often than every 96 hours.

The infusion nursing society recommends changing "intermittent" tubing every 24 hours, but by "intermittent" they are referring to tubing that is intermittently connected, not intermittently infusing such as a secondary line. Their 24-hour recommendation for intermittently connected tubing is only sporadically followed by facilities as it makes little to no sense and based on the evidence could actually increase the risk for introducing bacteria. The only tubing that should be changed q 24 hours are ones which contain solutions where bacteria can quickly propagate (lipid containing solutions, TPN, etc).

[tejon, DNP, NP]

We change tubing every 96 hours as well.

[IVRUS, BSN, RN]

This really depends..

If your patient has a primary fluid and then a secondary is needed for IVAB and compatibility has been assessed, then the secondary can be used for the same duration as the primary tubing, which is usually 96 hours, BUT only if you back-prime. If you are DISCONNECING the secondary tubing from the primary and purging the fluid through and reconnecting it to the primary set, then that tubing should be a 24 hour tubing. All of the connection and disconnection really DOES increase bacterial counts with all of the manipulation. BUT YOU REALLY SHOUL BE FOLLOWING YOUR AGENCY POLICY... What do they say?

[Karou]

Go by your facilities policy. Ours is 96 hours for continuous and 24 for intermittent. All tubing gets labeled when hung with that date and the due change date.