IV tubing change

Specialties Infusion

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shirokuma

7 Posts

Specializes in ICU, PACU.

some California hospitals are q96h for maintenance iv and pressure tubing

q12h for propofol

q24h for tpn

in Canada, Insulin was changed q24h (bag and tubing)

hugman95

2 Posts

Specializes in Geriatrics, Home Health, Rural ER.

We change continuous IV tubing q72h, intermittent IV tubing q24h and piggyback q24h.

:smilecoffeecup:

rnseb65

9 Posts

Specializes in Vascular Access.

Our hospital recently changed our policy from 72 hours to 96 hour change on the primary tubing.

SUE:nurse:

pooh54

91 Posts

Specializes in Level 2 and 3 NICU, outpt peds.

The CDC has guidelines on tubing changes that have been in effect since 2002 and updated in 2005, it's been a great help in getting our policies changed! The idea is to decrease tubing changes to help decrease the incidence of catheter related blood stream infections, great resource!

iluvivt, BSN, RN

2,774 Posts

Specializes in Infusion Nursing, Home Health Infusion.

The Infusion Nursing Standards of Practice published in Jan?FEB of 2006 Volume 29 Number 1s in standard 48.1 states Primary and secondary continuous administation sets shall be changed no more frequently than every 72 hours and immediately upon suspected contamination or when the integrity of the product or system has been compromised. As stated above there are special circumstances where tubing needs to changed sooner. Most TPN protocols are q 24 hours especially when lipids are piggybacked in. The Lipids increase the chance for infection more so than the high glucose content. Blood tubing should only be used x 1 and hang time no greater than 4 hours. Some of the lipid based medications and chemotherapeutic agents also have shorter times like Propofol is q 12 hours...again lipid based medications gives you a clue since these ahve a higher risk for infection. Hope this helps.

dmartinlpn

1 Post

There have been new standards set for IV tubing change. According to the INS tubing should NOT BE CHANGED ANY MORE FREQUENTLY than 72 hours, unless it is hyperalimentation running through, then every 24 hours, unless contraindicated.

Also, site changes should be every 72-96 hours, but not more frequently unless phlebitis, infiltration, etc. The only other time the IV site should be replaced is if it was put in during an emergency, then it should be changed WITHIN 24 hours due to the possible break of aseptic technique.

Hope this helps

Specializes in Psych/CD/Medical/Emp Hlth/Staff ED.

There seems to be a basic misunderstanding regarding terminology. It appears that the most common policy reflects the current CDC recommendation that primary and secondary tubing not be changed more often than every 72 hours, with exceptions for lipids and other specific medications. Others have policies to change primary tubing 72 hours and "secondary intermittent/piggyback" tubing every 24 hours. At my hospital we actually have both of these policies in effect currently. This somehow does not seem contradictory to many nurses I work with. All secondary tubing is by definition intermittent. This is because the basic definition of secondary tubing is that it is what runs for a set volume and then allows the primary tubing to take over again. Some nurses believe that if you have two lines, both running continuously through separate pumps, in which one Y's into the other below the pumps, one becomes the primary the other becomes a "continuously running secondary". It doesn't matter which is Y'd into each other below the pump, because they're both primaries. So if we can agree that "Primary and Secondary tubing" includes "intermittent secondary tubing, then it would appear that many hospital's not only do not reflect the most evidence based recommendation available, but are in direct opposition with the CDC's recommendation that both primary and secondary tubing not be changed MORE OFTEN every 72 hours.

Specializes in Psych/CD/Medical/Emp Hlth/Staff ED.

I'm trying to figure out how nurses define different types of IV tubing, and noticed you mentioned "piggyback" tubing, how do you define piggyback tubing?

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