PICC dressing change - clean the tubing?

[LesYou]

When you change a PICC or midline dressing, do you clean the tubing also? Specifically, the tubing from the insertion site to the hub. If so, what is your method? My company's policy does not mention doing this and most of the resources I've found on the internet do not mention it either. It seems to me that cleaning the tubing would help prevent infection.

[wheatfree, RN]

Yes. We use chlorhexadine swabs to clean our picc line sites. I use the sterile gauze in the pack to move the line out of the way to clean the site. Then I clean the line, let everything dry, apply skin prep, biopatch, securement device, and cover with opsite dressing. I'm going to clean anything that goes underneath that dressing and didn't come out of my sterile dressing kit.

[LesYou]

Thanks for your reply.

[Mr know it all]

Saline flushes keep the tubing clean, but only the required cc amount. Then Heparin will 'lock' the picc line tubing with an even safer solution for the mid term time until next, TPN 'feeding'.  That limited Heparin amount designated with physician considering patients particular needs, (weight, age, allergies, sensitivities).  Yeah you don't want to touch that tubing with anything. And thank the forces that be that there is finally a tool available to hospitals for LIPID- LOCK. When connector and hub get stuck!  I have seen hubs get cracked from 'fools' using a hemostat and strap to try to loosen stuck TPN connectors. Great, patient has to have a whole new line inserted. That needs to be a problem of the past. Share the word. The company that is providing free samples is RXTOOLS.org  Part of 'first tray' dressing changes as a must I say. Tell your charge nurse, there's a better way, hooray.

[Mr know it all]

other than cleaning swabs, alcohol pads, of course. 

[Mr know it all]

Just to note, gently cleaning that tubing is tricky business. It is easy to re-tear the skin around the actual insertion site.  It is a thing to be proud of when you see the skin grown over and around that area. Try not to move tubing, dab dab dab, then the other side. Don't wipe.