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Donna Betz
saline flush frequency

In our Home Infusion practice we are now doing PICC maintenance with 10 cc saline flush q 12 hours. One of our pharmacists suggested we change our policy to Q 8 (ie Q shift flushing). Not sure this is necessary - potential increased infecton rate  with extra entries to the line.   We recently (in March) changed our protocol and discontinued heparin use for PICCs after the heparin recall and a simultaneous switch to the microclave. We are tending to have an increase in catheter occlusions...? related to the deletion of heparin and/or change to microclave and/or noting an increased use of Double lumen PICCs being placed?? We are trying to track these trends . What are the thoughts on increasing this flushing frequency

This has been a common

This has been a common thought in the past but there is no science to support its use to decrease lumen occlusion. Are you flushing with the proper technique after each use? Clamping at the correct time? Following manufacturers instructions for flushing technique? If so, that is all you can do. Increasing the frequency of flushing will increase hub manipulation and the risk of contamination. Also, if this is a technique issue, more frequent flushing may only compound the problem. If the cause is inside the vein and not inside the catheter lumen, flushing more frequently will not change anything. There are 3 studies that have looked at saline only flushing and the occlusion rates ranged from 6% to 11% with just saline. I am not convinced that saline only is what we should be doing for any catheter or connector, but can also understand the desire to stop using heparin flushes. Until we have alternative locking solutions we are stuck with choices that are not great.  


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

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