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Frequency of changing IV Tubing-outpatient infusion suite

I work in an outpatient infusion suite where we administer mostly IV antibiotiotics.  Patients return every day for their daily dose and we were told to use the tubing for 3 doses.  we recap with a sterile cap after each infusion and label tubing according to day change.  Does this practice follow the INS/CDC guidelines?? 

mary ann ferrannini
If I am understanding you

If I am understanding you correctly you have a patient that comes in for a daily dose of an antibiotic and then he leaves after the dose any you save the tubing for the next day!!! Right...YIKES...that is not best practice IMO for a couple of reasons...First primary intermittent tubing should be changed every 24 hrs...Secondly, how do you verify that nothing has compromised that tubing especially since I am sure you close that dept overnight. What should be happening is that you use a new tubing for the dose when the patient comes in THEN TOSS day do the same thing. An infection is way more costly in many ways than a new IV tubing!!!!

I'm still looking but I

I'm still looking but I haven't found any literature to support that practice. Just the idea of it would make me extremely uncomfortable for many reasons. One being cross contamination and too much room for compromise and infection. Is that written in your policies and procedures? I would play it safe and use one new sterile set for each infusion, and open it only at the time of infusion.


mary ann ferrannini
INS does say primary

INS does say primary intermittent to be changed q 24 hrs..would have to look it up to get the page and number of that standard

In the infuson center I work

In the infuson center I work in we sometimes use a new tubing for asecond dose the same day. If it is a quiet day it doesn't seem to matter much, but when we are really busy I like to be sure that the tubing has been unmolested. Occasionally I am asked to defend my use of IV tubings, and the Infection Control nurse supports tossing the tubing daily and anytime I am uncomfortable reusing a tubing. Your IC nurse may be a good source of support.

Gail Mccarter

Gail McCarter, BSN,CRNI

Franklin, NH

What you have described is an

What you have described is an intermittent administration set. INS standards of practice state these sets should be changed every 24 hours. So the answer for any outpt infusion center is to toss it out each day at the end of infusion. In addition to contamination of the male luer end, there is the risk of mixing up tubing between patients and maintaining these sets overnight in a control setting. How do you actually know that nothing has happened to that set when housekeeping or others enter your dept?

The confusion comes because CDC guidelines do not recognize the difference between a set used for continuous infusion vs one for intermittent use. So they state change it no more frequenctly than 72 hours and that is where you are getting the 3 daily doses. The reason CDC does not state anything differently is because there is absolutely no studies about intermittent tubing. All studies have been done on continuous sets, and have either stated they eliminated all tubing used to give medication or they did not include any information on intermittent med tubing. So there is no evdence upon which to base this extended use. CDC guidelines also state to use only a sterile device to access any catheter. There is no evidence that tubings used multiple times remains sterile. 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

Jan Hull
We routinely change all

We routinely change all tubing that is disconected at least every 24 hours or if integrity of the tubing is compromised.  We label the tubing with the patients name, date and time and keep it tucked into there chart.  We are going to go to an EHR soon and will have to alter the practice when there is not any paper chart.  We very rarely will do antibiotics 3 times a day. 

Jan Hull, RN, CRNI

Jan Hull BSN, CRNI
[email protected]

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