Forum topic

INS standard is 72 hours. CDC guideline is 72 to 96 hours. Extending the tubing life to 96 hours for continuous tubing is certainly possible. If this is chosen, I would definitely extend the catheter dwell time to 96 hours also because they both should have the same dates. I would closely monitor nursing practices with this tubing and site however. Do you allow a needleless connector to be used in the tubing system? The presence of these devices allows for very easy connection and disconnection, thus increasing hub manipulation and the risk of infection. What is done with this tubing while it is disconnected? How is the male luer end protected? How do you ensure that the tubing is properly reconnected? What is the policy for intermittent tubing changes? How closely do your nurse monitor the infusion site? Do you require the use of handboards when a site is in the hand or wrist? When the patient complains of any discomfort, do the nurses immediately respond approrpriately by removal and restart? Or do they try to explain away the discomfort as related to a certain med or the solution temperature? Do they know how to do a proper site assessment included flushing and positive blood aspiration before each med is given? Do they thoroughly document these facts? These comments are based on problems I have seen when reviewing medical records involved in a lawsuit. With adequate policies, procedures, and a nursing staff that adheres to your p&p, I think it is quite possible to safely extend the dwell time to 96 hours. But I would want to assess all of the mentioned factors first. 

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

www.hadawayassociates.com