Current evidence for changing peripheral IV site frequency is: change site when clinically indicated.
What about IV tubing changing, is there any clear evidence to change IV set along with prick change (when clinically indicated).
If the recommendation to change IV set is every 96 hours and IV site when clinically indicated; then what about practicality of changing IV set and keeping IV prick? is consider safe to open the system? what are the alternatives?
Jun 10, '17
I am not an official expert on this, but what we do at my hospital is change the tubing every 96 hours independent of then the IV site is changed. Now, if I put in a new IV and the tubing is already 72 hours old, I will probably change it. And of course some tubing is changed much more frequently (blood/albumin every 4 hours, propofol 12 hours, TPN 24 hours as examples).
You ask whether it's safe to open the system. Well, we do it a lot! I think *ideally* you could connect the tubing once and only disconnect it once 4 days later, but practically I disconnect and cap the tubing when getting a patient out of bed (especially if their IV site is in a tricky spot). Once they are settled in the chair I scrub the hub, throw away the cap, and re-connect. I'm also not a fan of leaving tubing connected to the patient when it isn't infusing. If they don't have continuous IV fluids running (but get periodic antibiotics) I will flush the IV site and cap the tubing in between administrations. So, we open the system frequently anyway!
Jun 11, '17
We change q96 hrs for continuous infusions, but our policy is every 24 hours for intermittent (honestly the 24 hour changes are not well adhered to, and even though it has been policy for a few years I think probably most nurses aren't aware of it). We label tubing with discard on (blank) date stickers and so a new admit with ivf orders gets labels to replace in 96 hours applied, then orders change and stickers remain...
Last edit by Guitar_Heroine on Jun 11, '17
Jun 11, '17
If changing the site when "clinically indicated" and not at set intervals as per old practice, I wouldn't wouldn't consider it necessary to change a newer set of tubing/bags etc for a new site. If the change is due to site irritation/infiltration etc. I've always considered site and tubing changes as an infection prevention measure, so in absence of infection s/s I probably wouldn't
Jul 7, '17
In a few places that I've worked, any trauma line or field line must be replaced no later than 48hrs and all tubing changed. They are considered "dirty".
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