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Central LIne Tubing Change

By Joan Beade posted 05-18-2011 10:51 AM

  

When changing your central lines, if you have lipids Y'd into your TPN are you changing your lipid lines every 24 hours down to the Y, and then changing the Y with the TPN lines every 72 hours?  We been struggling with the thought that everthing with lipids running in it should be changed every 24 hours, but don't want to change all lines that frequently.
Thoughts?

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Penny Fuller
05-31-2011 07:56 AM

We have also struggled with this. We made the decision to leave the PICC, extension set and needleless access device in place for the duration of the PICC. The needleless access device is changed every Monday and Thursday using hat/ mask and sterile gloves to maintain the integrity of the open line.
Anything above the needleless access device is changed every 24 hours if TPN/IL or every 72 hours if it is crystilloids. OUr line sepsis rates are very low so it is working. We clean all needleless access devices with 3.5% Chlorhexidine upon accessing.

Kim Cooley
05-19-2011 07:38 PM

Joan
The new standards read differently than the previous. This is the statement from 2011 INS:
S56 Practice Criteria
IV. Parenteral Nutrition
C. When primary administration sets used for PN are exposed to IVFE, consideration should be made to changing the administration set every 24 hours. Limited evidence suggest an increased risk for infection when duration of administration sets is extended beyond 24 hours.

Kim Cooley
05-19-2011 06:58 PM

Joan
I have struggled with this topic as well. The 2009 CDC Guidelines were kind of vague to me but I thought the INS standards were more clear cut. We change our IL & HAF solution & tubing q24 hours. I will look at the new INS standards tonight and will post the standard statement.