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RiderRN
Changing Add-on Devices & Dsgs in IVs

Looking for input on how other institutions manage the add-on devices and dressing changes for PIVs where removal is clinically indicated.

INS is vague IMO. #36,2,C. "Change the add-on device with new vascular access insertion, with each administration replacement or as defined by the organization,..."

I interpret this as changing the add-on (extension tubing) with administration tubing changes. Would that be applicable to TPN/Propofol infusions, too?

Would anyone share their best practice? I am trying to find the IFU for the products we use.

Thanks.

Kate

 

lynncrni
You did not include the

You did not include the entire statement from INS SOP 36. "Change the add-on device with new VAD insertion, with each administration set replacement, or as defined by the organization and whenever the integrity of the product is compromised or suspects of being compormised." Ranking is V. This means low level of evidence for this statement and NO evidence to make a more definitive statement. Published evidence is required to guide the standards. The criteria listed use OR instead of AND. Each facility should assess their patient population, type of infusion therapy, and staff skill mix and make the decision that is best for you. IMHO, for a PIV, the attached extension set remains for the life of the catheter. Think about the PIVs designed with a permanent set attached like Nexivia. There is no way to change that, regardless of how long the catheter remains in place. If you intend for dwell time longer than 7 days, I would hope you are using complete aseptic technique for insertion and that means attachment of the ext set would be under the best conditions. I would change all needleless connectors at least every 7 days and leave the extension set. For dressing change on these PIVs, see page S82, Practice Criteria I, change at least every 5 to 7 days, again with ranking of level V, low level due to lack of evidence for a higher ranking. 

 

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

RiderRN
Thank you, Lynn. You are the

Thank you, Lynn. You are the best.

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