Just wanted to see what everyones practice was on changing end caps on cvcs especially piccs. Should it be every 3 days with tubing changes or every 7 days with dressing changes? This is considering the cap is not contaminated or cored out because we know it should be changed then. thanks
All needleless connectors should be changed at the same interval as the continuous IV set - which should now be no more frequently than 96 hours. However, I have a strong opinion that there should not be a needleless connector used when the fluids are a continous infusion. It serves no real purpose, adds to the risk of CRBSI, and increases the cost. These NCs were designed for use on catheters used for intermittent infusion. Changing them every 4 days would be within the standard of care, although the intermittent set should be changed every 24 hours. I would not go out to 7 days for the NC due to the risk of biofilm growth inside them, especially after 5 days when the biofilm reaches a steady state. Lynn
Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
How about accidental disconnect and desangunation?
"However, I have a strong opinion that there should not be a needleless connector used when the fluids are a continous infusion. It serves no real purpose, adds to the risk of CRBSI, and increases the cost."
Peter Marino R.N. BSN CRNI VA-BC Hospital based staff R.N. with no affiliation to any product or health care company.
The NC can just as easily become disconnected like the direct connection. Both a luer-locked and both can be loosened. In fact, I have heard many nurses say that a clear NC connected to a clear IV set is especially difficult to make the disconnection, increasing the risk for the NC to be loosened or totally unscrewed. The presence of an NC in a continuous line does not add any measure of safety in my opinion. It only adds risk for infection and is unnecessary. Lynn
Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861