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 standards or guidelines stating exactly what you are looking for.
Lynn Hadaway, M.Ed., RN, BC, CRNI
www.hadawayassociates.com
Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
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?
Deb