Collaborative Intravenous Nursing Service (CINS) Guidelines

Central Non-Tunnelled Catheters – Blood Sampling (CVC3)If a triple or quadruple lumen catheter is being used more than once a day there is no need for a Hepsal flushFor multi-lumen non-tunnelled catheters ideally one lumen should be used for blood sampling.ActionEquipment RequiredDressing Pack containing sterile towel and glovesGauze swabs x 310ml syringes x 3Chlorhexidine Gluconate 2% in 70% Isopropyl alcohol or 2% Chlorhexidineimpregnated wipe10ml 0.9% Sodium Chloride for injection5ml Heparin 10units/ml in 0.9% Normal SalineTwo green needles/filter straws. Sharps containerSurgical tapeAlcohol hand rub/gelApronNeedle free I/V access connector change as per manufacturer’s guidelines see NSF1Cins guideline Before the procedure begins make sure that your hands are washed and driedthoroughly and that they continue to be decontaminated during the procedure. A plasticapron should be worn.• Maintain aseptic technique at all times.• Explain the procedure to the patient. Ensure that valid consent is gained.• Ensure working area is as clean as possible.• Ensure all equipment is gathered before commencing the procedure and all packaging isintact and in date.• Inspect the catheter exit site for signs of skin discolouration or signs of infection e.g.exudates from exit site. If you suspect infection please contact the hospital team whoplaced the catheter for advice. Refer to trouble-shooting guide.• Open sterile pack allowing inner pack to fall onto clean working area.• Open out sterile pack to create a sterile field. Open remaining equipment ensuring nocontamination of sterile field.RationaleMaintain asepsis and safety.Reduce risk of infection.Reduce anxietyPatient complianceTo avoid contamination.To ensure that the procedure can becarried out safelyTo maintain a sterile fieldChlorhexidine based solutions are25The CINs group hereby assert their moral rights tothe works herein in accordance with the Data Protection Act 1988.Policy review date 01/10/10