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Denise Shuler
Central Line PICC line Tubing Change

Our Nurse Practice Council had this question ask to them. This is in light of the new federal regulations for not reimbursing central line infections.

Should all solutions and tubings be changed when infusions are initiated into a new central Line or new PICC line?

Should only tubings be changed?

Should tubings and/or infusions be changed when transferring from a peripheral to a new central line or PICC line?

Wuold this make a difference if the central line was changed for a possible sepsis or thrombus?

What practice do you follow?

Do you have any evidenced based references to support your practice?

Thank you so much.

I have never seen any

I have never seen any studies examining these issues. So you must reply on lower levels of evidence, but still considered forms of evidence. This would be the basic principles of infection control. The risk of contamination of sterile ends of all IV tubing is unknown. There could easily be touch contamination when the tubing was originally connected, along with growth of mainly gram negative organisms in the IV fluid itself. So moving a used fluid container and/or administration set from a old catheter to a new catheter of any kind could pose a risk of cross contamination to the new catheter. Again, I have never seen any studies that provide quantification of this risk. It is my professional opinion that it is alway wise and most appropriate to change the fluid container and sets when inserting a new catheter. The only time when this may not be necessary is when a short peripheral catheter was placed with new container and set and a mechanical problem occurs within a few hours requiring that the site be changed. When the date on the site and date on the set remains the same and the reason for restart does not involve any question of an inflammatory or infectious process (e.g. phlebitis) then I might choose to use the same set on a new catheter. I would simply change the short extension set that I would prefer to use on all sets. Anytime a new central catheter of any kind is placed, I believe it is most advisable to begin with a new container and set. 


Lynn Hadaway, M.Ed., RN, BC, CRNI

Lynn Hadaway, M.Ed., RN, BC, CRNI

Lynn Hadaway Associates, Inc.

126 Main Street, PO Box 10

Milner, GA 30257


Office Phone 770-358-7861

Gwen Irwin
Our rationale is that a PIV

Our rationale is that a PIV wasn't placed in a sterile field.  A PICC is placed in a sterile field.  We ask for new tubing to be used before transferring the fluids to the PICC.  We don't ask for new infusion fluid containers.

No studies.  Trying to use common sense.

Gwen Irwin

Chris Naylor
We change all tubing on a
We change all tubing on a new line
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