Routine PIV changes

[KelRN215, BSN, RN]

I had a dream last night that I was arguing with adult nurses about this (no idea why since I don't work in acute care and don't deal with PIVs anymore) and it got me wondering what other places do.

I know in the adult world, it is considered standard practice to change PIVs every 72-96 hours. Never done such a thing in pediatrics (though, let's be honest, we can count on one hand the number of peripheral IVs that are still in 72-96 hrs later). When I worked in the hospital, our original policy was to change q 7 days. Before I left, this policy changed and as long as the IV was functional, we were allowed to keep it and continue to use it. So theoretically a peripheral IV could remain in place for 10 days, 2 weeks or longer.

What do your work places do?

[umcRN, BSN, RN]

Hang on to it like it's gold! If you can get a PIV in a cardiac kiddo (which is where I work) it's not likely to last more than a few days but we will hold on to it for dear life for as long as it lasts

[~PedsRN~, BSN, RN]

If it ain't broke, don't fix it!!!

(Of course, run a day or so of vanc thru a 24 and it's going to go bad. Fast.)

[umcRN, BSN, RN]

Plus, why traumatize the kids with routine changes??

[Double-Helix, BSN, RN]

No routine changes for us. If it works, we use it, not matter how old it is.

[ChristineN, BSN, RN]

When I did adult med-surg we were supposed to change PIV's every 96hrs unless we got a physician's order saying it was OK to keep in in. When I worked peds we never changed them. However, I will say peds is the only place I never saw an infected PIV, had been in for over 1 week and had nasty white drainage coming out when we finally pulled it (wasn't infiltrated, the drainage looked like pus). The kiddo ended up staying in the hospital longer for IV antibiotics

[Pediatricjo]

ChristineN, I never thought of that. I just took it for granted. We leave ours indefinitely for the above stated reasons. When we did Outpatient Infusion therapy on our Pedi unit we didn't have infected PICC lines or Central Lines or Ports. 6 years of Pedi nurses doing this. The infections & such came from adult inpatient units. We did have an issue with PICC lines clotting frequently though. Our research basis for the policy was INS & so on.

[W317]

Our PIV last forever lol, our PICC line last even longer even when we have a line infection, the kid will be on IV-abx but we still kept the line. if you don't use them why keep them,

[KelRN215, BSN, RN]

Oh yeah I've also seen many an infected central line that we tried to save by doing "antibiotic locks".

[umcRN, BSN, RN]

Oh yeah I've also seen many an infected central line that we tried to save by doing "antibiotic locks".

I've only seen this once but it was a kiddo in whom this was literally her LAST point of access (they had actually put PIVs in her abdomen!) and she was already oscillating, on iNO, maxed on dopa/epi, barely hanging on. She did survive though!

[anon456, BSN, RN]

We also leave PIVs in for as long as needed, as long as they still work and look good. I had one patient's PIV that was in their AC and it lasted nearly 3 weeks!! It was redressed several times, but got great blood return. It was used for frequent labs. I was so mad when a nurse took it out before my shift started, simply because it had been in too long. I had to call the IV nurses to put in another one and the patient was traumatized and that one did not work as well.

PICCS are also kept in for as long as needed, with stringent inspections of dressings and Q7day dressing changes at the very least. We have a pretty low rate of infection.

[kidzrn08]

We also leave our PIV's in as long as they're good! We change the dressing and arm boards PRN but guard them with out life!!