I was wondering if everyone is changing their caps after every blood draw. In our ICU, RNs are drawing blood as often as every 2 hours. We are starting to hear some facilities are changing their caps less often (we use FloLink) and seeing a decrease in CLABSI--the theory being opening the line every 2 hours to change the cap increases the infection risk more that leaving the cap on after a blood draw. What is the opinion out there? Anyone else have similar results? What is your policy for changing the caps?
It has become common practice to change needleless connectors after blood sampling, but there is no evidence to support this. A recent study in JIN found that drawing blood cultures through the old cap lead to a higher rate of "false positives" so their recommendation was to change caps before drawing a blood culture. Also, if you obtain a brisk blood return from all CVCs, which is the recommendation before each use, then blood is going to come into the NC at that time. What is the difference between this blood exposure and drawing an actual sample? On the other hand, all NCs should be flushed until they are clear of blood, but some are opaque and the nurse can not determine if blood still resides in them or not. There is no evidence-based answer yet that I know about.
Lynn Hadaway, M.Ed., RN, BC, CRNI
www.hadawayassociates.com
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