[Klintworth, Gemma]

Hi Michael,
We reviewed our CVAD guideline early last year and have recommended the
following timeframes for administration line changes:
Parenteral nutrition – 24/24
Antimicrobial impregnated CVCs – 7 days (these are the predominant lines
in ICU)
All other CVADs (non AB impregnated) – 96 hours
This has largely been based on the 2011 CDC guidelines and also some of
the references given by Claire.
These timeframes are meant to be for continuous infusions as we try to
discourage reconnection of lines. This is our recommendation
organisation-wide, including for our haem patients.
Hope this helps.
Gemma
Gemma Klintworth
Infection Prevention Nurse Consultant
Infection Prevention and Healthcare Epidemiology

t 03 90762250 e G.Klintworth@alfred.org.au

m 0419 383 840

Alfred Health
55 Commercial Road
Melbourne VIC 3004
PO Box 315 Prahran
VIC 3181 Australia

Alfred Health incorporates The Alfred, Caulfield Hospital and
Sandringham Hospital
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Behalf Of Michael Wishart

Hi all

We are reviewing our central line policies and have two different
standards for administration set (line) changes: one for oncology
haematology, and one for every else, including ICU. Haem/onc routinely
change administration sets for all central devices (CVC’s and PICC’s)
every three days (dressings and needleless access devices changed every
7 days), whilst everyone else routinely changes everything
(administration sets, needleless access devices, dressings) every 7
days.

Is anyone aware of any specific data supporting more frequent line
changes for haem/onc patients? Is it standard practice in other places
to change all administration sets for central devices every 7 days?

Thanks for any discussion (and specifically supporting evidence) on
this.

Cheers

Michael

Michael Wishart

Infection Control Coordinator

Holy Spirit Northside Private Hospital

627 Rode Road, Chermside, Qld 4032

t: (07) 3326 3068 | f: (07) 3607 2226

e: Michael.Wishart@hsn.org.au

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[Klintworth, Gemma]

Hi, thanks for your responses. I agree that changing the needleless
access device every 24 hours and ‘opening’ the system so frequently may
introduce additional risk and would be costly.
For other solutions, we recommend changing the needleless access device
along with continuous infusion administration lines (but no more
frequently than 72 hours) as per the CDC. The issue with TPN lines is
therefore inconsistent with this.
Gemma
Gemma Klintworth
CLABSI Project Coordinator
Infection Prevention and Healthcare Epidemiology

t 03 90762250 e G.Klintworth@alfred.org.au

Alfred Health
55 Commercial Road
Melbourne VIC 3004
PO Box 315 Prahran
VIC 3181 Australia

Alfred Health incorporates The Alfred, Caulfield Hospital and
Sandringham Hospital
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Behalf Of Tim Spencer

Hi Gemma,

As far as I know, there is no specific literature that describes
needlefree caps/valves to be changed specifically in PN patients.

However, that said, going off current international guidelines and
recommendations, I would say a weekly change is justified.

Most PN admin sets are changed at 24hrs (if a 3 in 1 solution) because
of the lipid content.

I see no reason to be changing the needlefree port at 24hrs as that
induces excessive cost as well.

I would maintain a 7 day change period unless clinically indicated to do
so.

I do have current PN European guidelines, so feel free to contact me if
you might like a copy.

Regards,

Tim..

Timothy R. Spencer, RN, APN, DipAppSci, Bach.Health, ICCert.
Clinical Nurse Consultant, Central Venous Access & Parenteral Nutrition
Service

Conjoint Lecturer, South West Sydney Clinical School | Faculty of
Medicine | University of NSW
Dept of Intensive Care, Level 2, Clinical Building, Liverpool Hospital,
Elizabeth Street, Liverpool, 2170, NSW, Australia
Tel (+61) 2 8738 3603 | Fax (+61) 2 8738 3551 | Mob +61 (0)409 463 428 |
Tim.Spencer@sswahs.nsw.gov.au | Timothy.Spencer@unsw.edu.au
200 yeas logo white.jpg

Behalf Of Klintworth, Gemma

Hi all,

With regard to administration of parenteral nutrition via a central
line, I’m wondering how frequently people recommend that the needleless
access device is changed (if one is used at all in this case).

Thanks,

Gemma

Gemma Klintworth
CLABSI Project Coordinator

Infection Prevention and Healthcare Epidemiology

t 03 90762250 e G.Klintworth@alfred.org.au

Alfred Health
55 Commercial Road
Melbourne VIC 3004
PO Box 315 Prahran
VIC 3181 Australia

Alfred Health incorporates The Alfred, Caulfield Hospital and
Sandringham Hospital
http://www.alfredhealth.org.au

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