Nursing How To’s: Central Line Catheter Dressing Change

A central venous catheter is a tube that goes into a vein in the patient’s chest. It helps carry nutrients and medicine into the body as well as is used to take blood when the patient needs to have blood tests.

Basically, these tests catheters are used when people need medical treatment over a long period such as if they need antibiotics or other medicines for weeks to months, if they need extra nutrition because your bowels are not working correctly, may be receiving kidney dialysis, and/or may be receiving cancer drugs.

Dressings are special bandages that block germs and keep the catheter site dry and clean. As nurses, it is imperative that we educate our patients on how to change their dressing properly so as to prevent infection. Below are the steps on how to perform central line catheter dressing change:

Equipment:

  • Bottle of alcohol
  • 4 x 4 toppers (2 packages)
  • Package of 3 Povidone iodine swabsticks
  • Clean medicine cup
  • Sterile Q-tips (8-10 packages)
  • Bottle of hydrogen peroxide
  • Tape
  • Povidone iodine swabaid
  • Skin protective agent swab
  • Tegaderm
  • Adhesive tape remover swab
  • Nonsterile gloves

Procedure:

  1. Wash hands thoroughly.
  2. Clean the surface of your work area with alcohol.
  3. Gather necessary equipment.
  4. Prepare supplies for use and place on the cleansed work area.
  5. Remove old dressing carefully to avoid any pulls or traction on the catheter, do not use scissors. Use tape remover to remove tape if needed.
  6. Pour hydrogen peroxide on two 4 x 4’s. Pick up by four corners, clean site again starting at exit site and cleaning outward. Repeat with second 4 x 4.
  7. Pick up dry 4 x 4 by pinching it and lay on exit site. Pat skin dry.
  8. Cleanse the catheter with Povidone iodine swabaid by wiping from the exit site to the end of the catheter. Avoid tension on the catheter by using a “pinching” action to move swabaid to end of catheter.
  9. Apply skin protective agent to the skin if necessary. Avoid areas of skin breakdown.
  10. Coil tubing over the exit site using sterile Q-tip. Allow clamp and end of catheter to extend out from under dressing.
  11. Cover with tegaderm.

Note: The dressing should be changed about once a week. It will need to be changed sooner if it becomes loose or gets wet or dirty.

 

Sources:

https://www.uichildrens.org/childrens-content.aspx?id=229179

Liane Clores, RN MAN

Currently an Intensive Care Unit nurse, pursuing a degree in Master of Arts in Nursing Major in Nursing Service Administration. Has been a contributor of Student Nurses Quarterly, Vox Populi, The Hillside Echo and the Voice of Nightingale publications. Other experience include: Medical-Surgical, Pediatric, Obstetric, Emergency and Recovery Room Nursing.

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