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Thu, 12/13/2007 - 17:03

Leann Kennedy

Catheter dwell times

Happy Holidays, all!

Does anyone have any references for how long catheters can stay in the body?Â I know from classes and basic knowledge the ideal times, but could not find any written source, including the INS.Â I need it for updating our P and Ps.Â Specifically, I'm looking for short-term, non-tunneled central lines, midlines, and Hohn catheters.Â I'm under the wire, so I'd appreciate anything anyone can send ASAP (pressure anyone?).Â Thanks.

Thu, 12/13/2007 - 19:25

Kristin Walker

I just happen to revising

I just happen to revising the policies this week for my hospital. Go to the CDC website and find the article "Guidelines for the Prevention of Intravascular Catheter-Related Infections". It is in this article and they also have a Table at the end of the article titiled "Summary of Recommended Frequency of Replacements for Catheters, Dressings, Administration Sets, and Fluids. Good Luck!

Kristin Walker RN, BSN, OCN Maui Memorial Medical Center IV dept.

Thu, 12/13/2007 - 21:34

lynncrni

You are correct about the

You are correct about the CDC guidelines being a valuable reference, but they specifically state the optimal time for removal of all central venous catheters is unknown. The research has not been done to established a good time frame using reliable statistical methods. So there are no recommendations for the dwell time of any catheter except short peripheral catheters. 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

Fri, 12/14/2007 - 15:37

(Reply to #3) #4

Leann Kennedy

This is my concern...we

This is my concern...we found a patient who was transferred to several floors, plus in and out of the facility. Next thing we knew, we discovered his non-tunneled central line was 6 weeks old. Under the CDC guidelines, this is okay, but would any of us feel comfortable with this type of line staying in so long? Our physicians would say "yes" since there is no guideline to say it needs to be changed. Lynn, what do you think?

Fri, 12/14/2007 - 17:17

(Reply to #4) #5

lynncrni

I would assess how it is

I would assess how it is functioning (resistance, blood return, etc) and what the insertion site looks like. Then look at how long the patient needs therapy. If only for a short period, I would leave the current line in place. If for a longer period, I would replace it with another type of catheter that would serve his needs for the remainder of the anticipated therapy. This would be a clinical decision based on each patient. There are no specific recommendations about length of dwell for these catheters. It could easily be argued that insertion of a new line would produce a greater risk of insertion complications as opposed to allowing the current line that is functioning well without any problems to remain in place. 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

Fri, 12/14/2007 - 16:45

Monica Preston

I would like opinions about

I would like opinions about two instances:

1. If a PICC becomes disconnected from tubing, valve, etc. the hub is considered contaminated. If it was a groshong PICC, could the hub be replaced and then be considered non-contaminated or should the PICC be replaced? Obviously, open ended PICCs would need to be replaced.

2. Does anyone monitor continuous O2 stas with epidural infusions? We currently do continuous O2 sats for all pts with PCA infusions.

Fri, 12/14/2007 - 17:22

(Reply to #6) #7

lynncrni

The chances are very great

The chances are very great for this PICC to already be growing a significant amount of biofilm, therefore it is already "contaminated". So I would not necessarily consider any catheter with a tubing disconnection to require replacement. I would also hesitate to automatically replace a hub, even on a Groshong, because I would consider this "repair" to have a greater risk of contamination than a disconnected hub. 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

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