Changing a Peripheral Venous Access Dressing

Goal: The patient exhibits an access site that is clean, dry, and without evidence of any signs and symptoms of infection, infiltration, or phlebitis. In addition, the dressing will be clean, dry, and intact and the patient will not experience injury.

1. Determine the need for a dressing change. Check facility policy. Gather all equipment and bring to bedside.

2. Perform hand hygiene and put on PPE, if indicated.

3. Identify the patient.

4. Close curtains around bed and close the door to the room, if possible. Explain what you are going to do and why you are going to do it to the patient. Ask the patient about allergies to tape and skin antiseptics.

5. Put on mask and place a mask on patient, if indicated. Put on gloves. Place towel or disposable pad under the arm with the venous access. If solution is currently infusing, temporarily stop the infusion. Hold the catheter in place with your nondominant hand and carefully remove old dressing and/or stabilization/securing device. Use adhesive remover as necessary. Discard dressing.

6. Inspect IV site for presence of phlebitis (inflammation), infection, or infiltration. Discontinue and relocate IV, if noted. Refer to Fundamentals Review 15-3, Box 15-2, and Box 15-3.

7. Cleanse site with an antiseptic solution such as chlorhexidine or according to facility policy. Press applicator against the skin and apply chlorhexidine using a back and forth friction scrub for at least 30 seconds. Do not wipe or blot. Allow to dry completely.

8. Open the skin protectant wipe. Apply the skin protectant to the site, making sure to cover at minimum the area to be covered with the dressing. Allow to dry. Place sterile transparent dressing or catheter securing/stabilization device over venipuncture site.

9. Label dressing with date, time of change, and initials. Loop the tubing near the entry site, and anchor with tape (nonallergenic) close to site. Resume fluid infusion, if indicated. Check that IV flow is accurate and system is patent. Refer to Skill 15-3.

10. Remove equipment. Ensure patient’s comfort. Remove gloves. Lower bed, if not in lowest position.

11. Remove additional PPE, if used. Perform hand hygiene.