Changing an intravenous container, tubing, and dressing is a critical nursing procedure that helps prevent infection, maintain patency, and ensure accurate medication delivery.
Purposes for Changing an Intravenous Container
- To prevent infections.
- To maintain patency of tubing.
Articles
- IV fluid bottle/container
- IV drip set-sterile
- Labels for applying to tubing, container and IV cannula
- Kidney tray/paper bag
- Sterile gauze piece.
Tray containing
For dressing:
- Sterile gloves
- Sterile gauze pieces
- Antiseptic swab
- Adhesive tape
- Plastic sheet/under pad.
Procedure for Changing an Intravenous Container
| Nursing Action | Rationale | |
| 1. | Before procedure Obtain the correct solution. Verify with physician order. Read label of new container. Check name of solution, expiry date, constituents and volume present. Check for any sediments, turbidity and colour change. | Reduces risk of error. |
| 2. | During procedure Wash hands. | Reduces risk of transmission of microorganisms. |
| 3. | Set up intravenous equipment by inserting insertion spike of tubing into container (as in previous procedure). Optional: Add medication to IV solution if required. Apply label to container-including medication added and timing.Prime the tubing with solution. Label the tubing with date and time of changing the tubing. | Communicates the details of medications added and change of tubing. |
| 4. | Prepare dressing equipment. Prepare strips of tape as needed for the type of catheter or cannula used and hang them from the edges of tray/table. Open all equipment, swabs, dressing, ointment, etc. Place plastic sheet/under pad under extremity. Don gloves. | This facilitates access after gloves are worn. Prevents soiling of bed linen. Prevents contamination. |
| 5. | Remove the soiled dressing and all tapes except the one which holds catheter/IV cannula/needle in place. Remove tapes and gauze one layer at a time.Discard the dressing in appropriate container. | Prevents dislodgment of cannula in case it becomes entangled between layers of dressing. Prevents contamination. |
| 6. | Assess IV site for infiltration/inflammation. If present, remove needle from the site. In this case, a new intravenous line should be started. | Reduces chance for further trauma to tissues. |
| 7. | Disconnect the used tubing. Place a sterile swab under the hub of the catheter. Clamp the tubing. Hold the hub of catheter with nondominant hand and loosen the tubing with dominant hand using a twisting motion. Remove the used IV tubing and place its end in the kidney tray. | This absorbs any leakage that might occur when tubing is disconnected. Holding the catheter firmly and gently maintains its position in the vein. |
| 8. | Connect the new tubing. Grasp the new tubing with dominant hand. Remove the protective cap at tip and secure it to the hub of cannula or catheter and fix it.Open the clamp to start free flow of solution. | |
| 9. | Remove the tape securing the cannula while holding hub of the needle with one hand. | Prevents inadvertent dislodgment of cannula or catheter. |
| 10. | Clean the IV site with adhesive remover if residues of adhesive tapes are present. Then use alcohol swabs or povidone-iodine swabs. Clean the site from center to periphery to a 2-inch diameter, starting from site where catheter enters the skin. | Facilitates new dressing to stick properly. Cleaning in this manner prevents contamination of IV site from bacteria on the peripheral skin areas. Antiseptic reduces the number of microorganisms present, thus reducing the risk of infection. |
| 11. | Recap the needle/catheter (as in procedure given before). | Reduces chances of displacement of needle. |
| 12. | Apply antiseptic ointment and apply dressing (sterile gauze over site) and fix it with adhesive strips. | Reduces risk of infection. |
| 13. | After procedure Label dressing indicating date and time of change, and secure IV tubing with additional tapes if required. | Communicates to all staff members about change of dressing and tubing. |
| 14. | Discard all used articles. | Reduces risk of transmission of infection. |
| 15. | Remove gloves and wash hands. | Reduces risk of transmission of infection. |
| 16. | Document all relevant information. | Enables communication between staff members. |
Special Considerations
- Change primary tubing every 72–96 hours, or per policy
- Change dressing every 7 days (or sooner if damp, loose, or soiled)
- Use chlorhexidine-impregnated dressings for high-risk patients
- Avoid touching the insertion site or catheter hub during dressing change
- Monitor for signs of phlebitis, infiltration, or infectio
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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