Collaborative Intravenous Nursing Service (CINS) Guidelines

container, place the filled syringes on the sterile field.• Place sterile towel as near as possible to the catheter.• Using a piece of sterile gauze soaked in alcohol Chlorhexidine solution, scrub the top then thesides of the needle free system connection and allow to dry.• Alternatively, scrub the hub of the needle free system with Chlorhexidine impregnated wipe,rubbing from the top of the needle free connector to the sides. Do this three times using differentparts of the wipe, over a period of 30 seconds. Allow to dry.• Attach syringe with 0.9% Sodium Chloride (saline) flush and inject the flush using a push/pauseaction, clamping as the last ml of solution is instilled into the catheter.• Remove the syringe and discard. Repeat flush now using Heparinised saline.• NEVER FORCE THE SOLUTION INTO THE CATHETER, this can damage the catheter• Ensure that the catheter is secure and comfortable.• Remove dressing towel and discard. Remove gloves. Wash hands.• Clear away equipment disposing of waste as per organisational policy.• Document care in patient’s records.24to blood sampling although the first sample canbe used for blood cultures (RCN 2005).There is an increased risk of infection andocclusion when withdrawing blood via a centralvenous catheter (RCN 2005), therefore for routineflushing of a line withdrawal of blood is notrequired. The pulsated flush creates turbulencewithin the catheter lumen, removing debris fromthe internal catheter wall (Goodwin & Carlson1993, Todd 1998).Positive pressure within the lumen of the cathetershould be maintained to prevent reflux of blood(INS 2000).10ml syringes should always be used; smallersyringe sizes may damage the catheter(Hadaway 1998).The CINs group hereby assert their moral rights tothe works herein in accordance with the Data Protection Act 1988.Policy review date 01/10/10