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Chris Thomas
Changing IV tubing

We are still trying to decipher the INS standard on tubing changes, continuous vs intermittent.


If infusate is intermittent, then it consitutes intermittent tubing changes.   However, there are two questions I have regarding this to stay complant.

1.  If we change our IV fluid bag every 24 hours for the continuous IV, does this contradict the definition of continuous iVF and require tubing change every 24 hours?


2. If intermittent tubing is maintained to the primary line and not disconnected but rather backflushed to clear the line before adding a new medication, does this make it continuous?


Thank you for any comments.

Chris Thomas, RN, MSN, CNP

Fairview Hospital of the Cleveland Clinic

The INS standards states

The INS standards states primary and secondary continuous, meaning that all tubing used for continuous infusion, both primary and the secondary med sets attached to the primary can be changed no more frequently than 72 hours. Fluid containers are all changed at 24 hours usually and this does not change the time interval for the primary continuous sets. Secondary med sets must remain connected and backprimed as you described. The issue with the intermittent sets is when you are connecting and disconnecting, multiple times to the catheter hub or the administration set and changing the fluid container with each dose. Both ends of those sets are being manipulated, therefore they have a greater risk of contamination and should be changed at 24 hours. CDC states that all needleless connectors must be accessed with a sterile device. We really do not have any studies at all on these intermittent sets so 24 hours of use may be resulting in a nonsterile male luer end. Lynn



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

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