Hi everyone!

I'd like to know how you manage and replace daily PICC and UVC (Umbilical Venous Catheter) lines. Have you some particularly attention or procedures to do that?

In our centre we usually prepare a sterile field, and two nurse in sterile dress prepare the new lines for all the babies, and this is such a big waste of time.

I don't want to speak about the iincreased percentage of probable errors in doing it like this (in terms of clinical risks), but i'm interested in how you manage this procedure.Do you know also some articles in literature, or some evidence based practices rather that some studies that can help me?

Thank you!

Edited June 18, 201015 yr by jacques-attack

Can anyone really answer to my question? This is really important for me....Thank you..

hello! I guess you mean the procedure to insert picc's and uvc's, we do not replace them unless very special circumstances.

In our unit, a picc is usually inserted by a single nurse, trained for the procedure. The arm/leg is draped in sterile dressings, and the nurse is dressed in a sterile gown as well.

Uvc's is inserted by a doctor, usually assisted by a nurse. Sometimes the dr does the insertion him/herself. Sterile conditions as above.

Thank you for your replies, but I think my question was wrong or not too much understandable. I 'd like to know how and when you replace TPN's lines for PICC and UVC's. We usually prepare and replace them with two nurses in sterile gown, who prepare them for all the babies in the NICU. Do you prepare them the same way, or every nurse does it herself only for the babies who cares about? Do you replace them every day? Any literature reference? Thanks a lot!!

Hello there. In our unit the TPN is changed every 48hrs according to the manufacturer's instruction. The procedure is carried out by two nurses, both of whom wear sterile hats and masks, and the nurse who is actually handling the lines wears a sterile gown and gloves. Each nurse is responsible for the line changes for the babies she is caring for and negotiates with the other nurses so that the lines are not all changed at the same time. We change lipids daily, again as per the manufacturer's instructions, and follow the same procedure. It is time consuming, but it has made a significant difference to our line infection rates. The nursing journal Neonatal Network has published several articles about handline and changing of fluids on PICC lines and UVCs over the last 5 years. I hope this information is useful to you.

Thank you! Your answer is very useful for me! I'm looking forward to collect all the references you have just mentioned. Thank you again!

Hello,

Here at my center, each nurse is responsible for changing the tubing of their babies' lines.

For all central lines, we clean a surface, and connect/spike all fluids on a sterile field before taking the field to the baby, cleaning the site/cap with Chlorhexidine pads. We change our clear fluid lines (UAC/UVC/PICC/AL, etc) q96h, and our intralipids q24.

We never disconnect the line once in place after the sterile field comes down. We can transfer the line to a peripheral site "clean to dirty" once we don't have the central line, but never a peripheral IV to PICC or central line, eg..."dirty to clean"

Our infection rates are extremely low.