After the line is placed, day one, when should the dressing be changed? If a product containing CHG is placed onto the site, is the dressing good for seven days? Our policy states we change the CVC (non PICC ) and the PICC at 24 hrs after insertion. For PICC Lines the dressing is chabged at 7 day interval. For CVC non PICC, non Tunnel, the dressing is changed every 72 hrs.
First and foremost, the dressing on all CVADs, PICC included, should be changed when dirty, wet, or non-occlusive regardless of when it was last changed. Routine dressing changes if using a TSM dressing should be done at least every 7 days. If using tape and gauze, the dressing should be done every 48 hours. The reason for a dressing change on PICCs within the first 24 hours was due to the original design of the introducer which left a much larger hole in the vein than the PICC left inside. This size difference allowed for bleeding around the site and thus the need to change it. If your facility is using the MST procedure especially with US, there will probably be no bleeding around the insertion site and thus no need to change the dressing in 24 hours. All CVADs should have the same policies and time intervals for changing the dressing. Lynn
Lynn Hadaway, M.Ed., RN, BC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
Thanks. I am currently in the process of revising the policy and needed a reference regarding routine interval changes. Currently we do not have a member of the Nursing Infusion Society. Again thanks for your help.
Both the CDC guidelines and Infusion Nursing Standards of Practice state virtually the same thing about dressings. CDC document is a free download. Your facility must also have the INS standards regardless of whether you have any members working at your facility. These are the documents used to measure your p&p and nurses performance especially in a legal case. The INS document can be purchased in a pdf format for a small charge. Lynn
Lynn Hadaway, M.Ed., RN, BC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861