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Deb Gnegy
New Fluids and Tubing when CVC is changed

Our CVAD policy states to change all tubing, add-on devices, and fluids when a CVC is changed.

I can't find an INS Standard or CDC Guideline to support this and I need ito satisfy a physician's request for information.

Standard 48.3 states to change the tubing when the peripheral is changed, but doesn't mention CVC. Common sense should deduce to do the same with a CVC.

Practice criteria "C" under Standard 29 states to change add-on devices with each catheter.  The term catheter covers CVC.

Our practice came into question after a surgeon changed a CVC that was suspected to be the source of sepsis--!!!

Is there any standard/guidline/recommendation to support our policy?  I'm looking for credible published documentation.

I don't expect much resistance with the tubing change, but I do expect resistance on the fluid change.

Staff use common sense. If there's time before the line change-out, they'll order new drips.

If there isn't time, and the drips can not be safely held to wait for new bags, it may be necessary to spike the existing drips with new tubing before connecting to the new line.

I am not aware of any

I am not aware of any standards or guidelines stating exactly what you are looking for. 

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

Lynn Hadaway, M.Ed., NPD-BC, CRNI

Lynn Hadaway Associates, Inc.

PO Box 10

Milner, GA 30257


Office Phone 770-358-7861

Deb Gnegy
I recently updated our

I recently updated our policy and left this inherited piece as it was.  I'm now being asked to defend it.

What is the Industry standard/general practice? Does anyone else have it in their policy to replace the tubing and drips and not to connect the "old" tubing to the new line?


mary ann ferrannini
 We have them change only
 We have them change only the tubing and I recently rewrote our CVC/PICC policy and left it as such. I was thinking that it would not be prudent to add the IVF and IV medications in that change as well. Some medications such as IVIG are very expensive and I would not expect them to get another dose. I thought it would be too confusing if we stated on these IV fluids change and on these do not.
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