Definition
Central venous catheter tubing is changed frequently to ensure minimal risk of infection. The frequency of change depends on institutional policy, the status of the client, and the type of fluid that is being infused.
Indication
- Clients receiving total parenteral nutrition.
- Clients with compromised immune system.
- Those who are neutropenic such as cancer clients undergoing chemotherapy.
- Clients receiving fluid for hydration and those with intact immune system require less frequent changes.
- Immediate change is required if the tubing is found to be damaged or contaminated.
Articles
A tray containing the following:
- Packet of central venous catheter tubing.
- Tag or tape with the date and time of tubing change.
- Medication or fluids as ordered.
- Sterile gloves.
Procedure for Cental Venous Catheter Tubing
| Nursing Action | Rationale | |
| 1 | Before procedure: Check the patient’s medical record for the type and rate of medication or fluid to be administered. | Helps identify need for catheter change. |
| 2 | Explain to client, the need for catheter change. | Enhances patient compliance with the procedure. |
| 3 | During procedure: Wash hands and don gloves. | Reduces the transmission of organisms |
| 4 | Prepare the medication or fluid as prescribed and assemble the articles | Ensures that the right patient receives the right medication using the right equipment. |
| 5 | Check the client’s arm band before hanging the new central venous fluids. | Ensures right patient. |
| 6 | Clamp off new tubing. Spike bag of medication or fluids with new tubing. Squeeze drip chamber until it is about half full. Open clamp on new tubing until medication or fluids have filled tubing completely. | Prevents air from being infused through the central venous catheter and causing air embolus. |
| 7 | Clamp off central venous catheter and old tubing if it is currently hanging. Disconnect old tubing from central venous catheter site. Connect new tubing without letting the end of the catheter or needle become contaminated. | Tips of catheter and tubing must be maintained sterile to minimize the risk of contamination and infection. |
| 8 | Insert tubing into IV pump if one is being used and unclamp the new tubing, adjust drip rate on the pump to infuse at ordered rate. | Ensures proper rate and prevents fluid overload |
| 9 | After procedure: Apply tag on tubing with next date for tubing change. Document tubing change in patient’s chart (Nurses’ notes). | Ensures that other nurses will be aware of da te the tubing needs to be changed. |
| 10 | Dispose off the used tubing according to the hospital protocol. | Complies with infection control policies of the institution. |
| 11 | Wash hands. | Reduces transmission of microorganisms |
REFERENCES
- Annamma Jacob, Rekha, Jhadav Sonali Tarachand: Clinical Nursing Procedures: The Art of Nursing Practice, 5th Edition, March 2023, Jaypee Publishers, ISBN-13: 978-9356961845 ISBN-10: 9356961840
- Omayalachi CON, Manual of Nursing Procedures and Practice, Vol 1, 3 Edition 2023, Published by Wolters Kluwer’s, ISBN: 978-9393553294
- Sandra Nettina, Lippincott Manual of Nursing Practice, 11th Edition, January 2019, Published by Wolters Kluwers, ISBN-13:978-9388313285
- Adrianne Dill Linton, Medical-Surgical Nursing, 8th Edition, 2023, Elsevier Publications, ISBN: 978-0323826716
- Donna Ignatavicius, Medical-Surgical Nursing: Concepts for Clinical Judgment and Collaborative Care, 11th Edition ,2024, Elsevier Publications, ISBN: 978-0323878265
- Lewis’s Medical-Surgical Nursing, 12th Edition,2024, Elsevier Publications, ISBN: 978-0323789615
- AACN Essentials of Critical Care Nursing, 5th Ed. Sarah. Delgado, 2023, Published by American Association of Critical-Care Nurses ISBN: 978-1264269884
- Ernstmeyer K, Christman E, editors. Nursing Fundamentals [Internet]. 2nd edition. Eau Claire (WI): Chippewa Valley Technical College; 2024. PART IV, NURSING PROCESS. Available from: https://www.ncbi.nlm.nih.gov/books/NBK610818/
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