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Changing medication bags with PIV site change

Several years ago our IV team began requesting that both administration sets/tubing and medication bags be changed when an IV is re-sited.  At this time our facility is questioning the practice of changing the medication container at the time of the placement of a new IV.  As I understand, we would, however, continue to change the tubing with the new IV.   I was reviewing standards (INS, CDC as well as discussion boards) in order to provide guidance on this practice.  Current INS standards recommend that the "administration set is changed whenever the peripheral catheter site is changed or when a new central vascular access device is changed" (INS 42.2)  I was unable to locate any specific recommendations regarding changing the medication container.  I located a discussion from this site from 2014 (12/19/14) at which time you stated "The standard is to change the container and IV set at the same time. If a container will not be infused by the time that container is empty, then the set should be changed when that container is hung. Respiking a bag is never a good idea but I don't know of any guidelines statements about this issue".  I agree with this statement and agree with the practice of changing both the administration set as well as the medication when an IV site is changed.  Since the writing of this posting in 2014 are you aware of any additional standards or research regarding this practice?  Extending this lack of EBP to central lines I wonder under what research/standard we have operated in which it is common practice to change all central line medications when changing medication administration from a peripheral IV to a central line.

Make sure you are reading

Make sure you are reading from the 2016 edition of the INS Standards. There are very few published studies on all administration sets and none that include med or piggyback sets. All admin sets are changed when a new catheter is inserted, peripheral and cental. The issue is the fact that the male luer end of the set has been attached to the VAD hub which has a great chance of being colonized. The piggyback sets and primary set should be changed at the same time to keep them all on the same schedule and avoid overlooking the change of the secondary piggyback at a time different from the primary. 

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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