Changing IV Dressings (Central Line Dressings)

Changing IV Dressings (Central Line Dressings)

Equipment
■ Clean nonsterile gloves.
■ Central line dressing kit (including sterile gloves, mask, sterile transparent semipermeable dressing, sterile tape, an antimicrobial agent, and a sterile catheter stabilization device).
■ Mask for patient.
■ A sponge containing the antimicrobial agent CHG may be used as a part of the dressing, as well.
■ Note: You can use povidone-iodine followed by alcohol as the antimicrobial if CHG is contraindicated and if the patient is not allergic to iodine.

Assessment
■ Observe the site for excessive bleeding, infection, or other complications.
■ Observe for signs of compromised catheter integrity: wet dressing, kinked, cracked, or leaking catheter.
■ Be Safe! Notify the primary provider if any of these signs are present.

Post-Procedure Reassessment
■ Evaluate the IV insertion site and surrounding tissue for signs of infiltration, inflammation, infection, and phlebitis.
■ Monitor the dressing for dampness, blood, soiling, or loosening.
■ Continue to visually inspect and palpate the catheter-skin junction site for tenderness daily through the transparent dressing.

Key Points
■ Be Safe! Care of CVCs requires meticulous aseptic technique.
■ Obtain sterile central line dressing kit and mask for the patient. If there is no kit, you will need at least a mask, sterile gloves, antiseptic solution, dressing, and tape.
■ Place the patient in a comfortable position. Some guidelines advise semi-Fowler’s.
■ Ask the patient to don a mask or turn his head to the opposite side if unable to tolerate a mask.
■ Don mask and clean nonsterile gloves.
■ Carefully remove the old dressing and stabilization device.
■ Inspect the site for signs of complications.
■ Remove and discard gloves and soiled dressing; wash your hands.
■ Don sterile gloves contained in the kit.
■ Scrub the site for 30 seconds, using swabs contained in the kit.
■ Scrub the sutures (if any) and the catheter, from insertion site to the hub or bifurcation.
■ Allow the site to dry.
■ Apply the dressing that comes in the kit.
■ Apply the new catheter stabilization device, if one is used.
■ Remove the drape, if one was used.
■ Loop the catheter gently and secure it with tape to the skin. Avoid securing it to the dressing.
■ Label the dressing with the date changed, time, and your initials.

Documentation
■ Chart the date and time the dressing was changed, and condition of the IV catheter insertion site.
■ Document any complications of IV therapy and the interventions taken. Document the dressing change on the IV record.
■ Often, IV care is documented on a flowsheet.