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Infusion Therapy Procedures Summary

PROCEDURE MINIMUM FREQUENCY(and PRN) CONSIDERATIONS
TRANSPARENT MEMBRANE DRESSING   Change immediately if:
  • Loose, not occlusive, moisture accumulation, drainage, redness, or irritation.
Initial dressings will be changed PRN if saturated, and 24-48 hours post insertion of midlines, PICCs, and CVADs if there is gauze present under the dressing or drainage is noted.
Peripheral With site change.
Midline Every 7 days. 
PICC or CVAD Every 7 days.
Implanted port With every non-coring safety needle change.
GAUZE DRESSINGS Every 48 hours.  
NEEDLELESS CONNECTOR On admission change connector to type used in facility. Integrity of valve/diaphragm is influenced by frequency of use, fluid composition, & viscosity. Change needleless connector immediately if compromised.
Routine meds/fluids Weekly.
Parenteral Nutrition Every 96 hours.
If there is blood in the cap Immediately. eg.: Post labs/transfusion/back-flow of blood.
EXTENSION TUBING
(with clamp) Add to any external catheter that has no clamp (except Groshong & similar valved catheters)
If extension set is added as part of original central venous access device insertion procedure under sterile conditions, it may be considered a permanent part of the catheter and changed only if contaminated or damaged. Sets added post-insertion are changed weekly or PRN. Use air embolism precautions if indicated.
INFUSION TUBING    
Continuous Every 96 hours.  
Intermittent Every 24 hours. Any tubing disconnected between infusions.

Parenteral Nutrition Infusion 
Lipids only infusion

Every 24 hours.
Every 12 hours.
 
Secondary With primary tubing. Do not disconnect from primary tubing between doses.
Back-prime tubing from primary by holding the secondary bag below the level of primary bag until drip chamber on secondary tubing is 1/3-1/2 full.
FILTERS Change with IV tubing. Use air-eliminating type.
0.22 micron Routine meds/fluids. Parenteral nutrition if NO LIPIDS in bag. Completely bacteria retentive. Fat molecules too large for 0.22 filter.
1.2 micron Parenteral nutrition/lipids in bag. Removes precipitates that may be masked by lipid emulsion.
No filter Lipids infused alone.
(1.2 micron also acceptable.)
Medications that cannot be filtered.
May be Y-sited below 0.22-micron filter of TPN tubing.
SOLUTION CONTAINER Within 24 hrs after being spiked. Inspect bag; verify label and expiration date prior to hanging.