We are currently updating our CVL policy and want to put in a statement requiring a tubing changing prior to hooking fluids/meds up to a new CVL (fluids previously running through PIV). Is this your practice? Also, when switching from one lumen to another or from one CVL to another, do you routinely change the IV tubing?
Without a doubt, any new catheter of any kind requires a new IV adminstration set. This is addressed in the INS Standards of Practice. All catheter hubs, especially if you are using a needleless connector in the system carries a risk of transferring organisms from one catheter hub to another. To reduce this risk of cross contamination, the national standard is to set up a new IV set for a new catheter. 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
We have always required new tubing when going from PIV to CVC. I have caught a few nurses not following this rule and watched them connect from a PIV to a new PICC I had just placed, even after I explain that most PIVs are not put in using clean or sterile technique, and are therefore considered dirty.
Since the above occurred more often than I was comfortable with, I simply cut all tubing and bags when I clear the PICC line for use. I do flush the PIV, and if the pt is on a medication that cannot be stopped, I mark the bag and tubing so that I know whether it was connected afterwards to the PICC. :)
New line, new tubing!!!! Always!
When obtaining blood cultures from a central line and there is no blood return, how long should one wait after patency has been established, either by flushing the line or cathflo has been instilled?
Can you please direct me to where in the INS standards this is addressed?
Thank you
Leigh Milazzo RN, BSN, VA-BC
Vascular Access Nurse
Hillcrest Baptist Medical Center
Standard #43, Standard statement 43.2, page S55. Please note this is a standard statement with a "shall" verb rather than a practice criteria statement with a "should" verb. 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