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Gwen Irwin
Intermittent tubing change every 24 hours

I know that there is no evidence to indicate that using intermittent tubing beyond 24 hours, but there isn't evidence that indicates it isn't safe either.  I also understand that the INS standards indicate that the intermittent tubing should be changed every 24 hours.  The articles that the INS uses are the ones that proved that exceeding 24 hours with continuously connected tubing didn't significantly increase the BSI rates.  Same type of study indicated exceeding 48 hour tubing changes. and so on. 

With that said, I know that many hospitals do not change intermittent tubing every 24 hours.  Lynn Hadaway published that in her survey of tubing change practice.

For those of you that do change every 24 hours, what is your evidence related to BSIs?  Do you have results before and after making a change in practice that shows an impact on decreasing BSIs?  Are you willing to share?  I really need this info.

As we are on the journey to weed out more and more BSIs, it is difficult to convince people of the other possible contributing factors.  Since there are so few BSIs, it becomes harder to see the impact of change quick enough to know that we are on the right track.  Does that make sense?  Hope so.

Thanks for any help.

Gwen Irwin

Austin, Texas

As you stated there is no

As you stated there is no evidence to support using an intermittent set beyond 24 hours. All studies on administration sets have ***only*** addressed continuous sets. Disconnecting and reconnecting an intermittent set on both ends with each dose can easily lead to contamination, although we do not have any published information about this. The only thing I can point you to is the fact that the CDC guidelines have always clearly stated that all catheters must be accessed ***only*** with a sterile device. We simply do not know that even 24 hours of use will still allow for a sterile set. The pending set of CDC guidelines is going to recognize that there is a difference between continuous and intermittent sets and state that the change interval for intermittent sets is an unresolved issue. I consider this a big step in the right direction. Now we need to get the needed studies on this issued. 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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