Collaborative Intravenous Nursing Service (CINS) Guidelines

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31References.1. Department of Health (DOH) (2001) Guidelines for preventing infection associated withthe insertion and maintenance of central venous catheters, Journal of Hospital Infection,47 Supplement S47 – S672. Department of Health (DOH 2003). Winning Ways: Working together to reduce healthcare associated infection in England3. Department of Health (DOH 2005). Saving Lives: A delivery programme to reduce healthcare associated infection including MRSA.4. Goodwin M, Carlson I (1993) The peripherally inserted catheter: a retrospective look at 3years of insertions, Journal of Intravenous Nursing, 16 (2) 92-1035. Hadaway L (1998) Catheter connection, Journal of Vascular access devices 3 (3), 40.6. INS (2000) Infusion Nursing Standards of Practice, Journal of Intravenous Nursing 23(6S) supplement.7. Treston-Aurand J et al (1997) Impact of dressing materials on central venous catheterinfection rates. Journal of Intravenous Nursing 20(4):201-206.8. Wille JC (1993) A comparison of two transparent film-type dressings in central venoustherapy. Journal of Hospital Infection 23(2):113-121.9. INS (2000) Standards for infusion therapy. Cambridge, MA: INS and Becton Dickinson(III). In RCN Standards for Infusion (2005).10. Masoorli S (2003) Extravasation injuries associated with the use of central venousaccess devices. Journal of vascular access devices. 21-23 SpringThe CINs group hereby assert their moral rights tothe works herein in accordance with the Data Protection Act 1988.Policy review date 01/10/10
Care and Maintenance of a Peripheral Inserted Central Catheter (PICC). (PL1)32EXIT DRESSING CHANGE (Weekly)ActionEquipment requiredDressing Pack containing sterile towel and GlovesGauze swabs x 3, Surgical tapeChlorhexidine Gluconate 2% in 70% Isopropyl alcohol or 2% Chlorhexidineimpregnated applicatorSemi-Permeable transparent IV dressingAlcohol hand rub or gelSkin closure stripsSkin fixation device (e.g. stat-lock)Plastic apronRationaleCare of Exit site Dressing changes should be performed on a weekly basis or when dressing is dirty orloose 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. 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.• 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.To prevent infectionExit site dressings are important inpreventing trauma and the extrinsiccontamination of the site of entry(Jones 2004).To prevent/reduce patient anxietyMaintain safetyTo minimise the risk of infection andcatheter contamination.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
Page 3 and 4: Intravenous Access Care and Mainten
Page 5: 4Cheshire and Merseyside NHS North
Page 8 and 9: Open sterile pack, allowing inner p
Page 10 and 11: Ensure all equipment is gathered be
Page 12 and 13: Skin Tunnelled Catheters - Blood Sa
Page 14 and 15: catheter.• Ensure that the cathet
Page 16 and 17: • Open sterile pack allowing inne
Page 18 and 19: Algorithm persistent withdrawal occ
Page 20 and 21: The CINs group hereby assert their
Page 22 and 23: Care and Maintenance of a non tunne
Page 24 and 25: Central Non-Tunnelled Catheters - S
Page 26 and 27: Central Non-Tunnelled Catheters - B
Page 28 and 29: Central Venous Non-Tunnelled Cathet
Page 30 and 31: Algorithm persistent withdrawal occ
Page 34 and 35: • Open sterile pack, allowing inn
Page 36 and 37: • Open out sterile pack to create
Page 38 and 39: 37Peripherally Inserted Central Cat
Page 42 and 43: • Place 0.9% sodium chloride (sal
Page 44 and 45: References431. Department of Health
Page 46 and 47: Care and Maintenance of a Periphera
Page 48 and 49: Peripheral Midline - 0.9% Sodium Ch
Page 50 and 51: 49Peripheral Midline -Administratio
Page 56 and 57: Put on sterile glovesPlace sterile
Page 58 and 59: ampoule(s) near to the working area
Page 60 and 61: 59Totally Implanted Venous Access D
Page 62 and 63: If TIVAD was accessed for flushing
Page 64 and 65: solution or open Chlorhexidine impr
Page 66 and 67: 65Care and Management of Peripheral
Page 68 and 69: 67Changing a Needle-free I/V access
Page 70 and 71: 69EXIT SITE INFLAMMATION/PHLEBITISP
Page 72 and 73: SYSTEMIC INFECTION71Signs & Symptom
Page 74 and 75: FOR CARE OF PERIPHERAL VENOUS CANNU
Page 76 and 77: Bleeding from site / lineitself.Lin
Page 78 and 79: 77Type of device Risks Actions Vari
Page 80 and 81: EVALUATION RECORD79DATE EVALUATION
Page 82 and 83:
Type of device Risks Actions Variat
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EVALUATION RECORD83DATE EVALUATION
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85Type of device Risks Actions Vari
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87EVALUATION RECORDDATE EVALUATION
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89Type of device Risks Actions Vari
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91EVALUATION RECORDDATE EVALUATION
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2List of contributors to the Venous
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4PCTcoordinatorMalcolm Smith Mid Ch
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6University Hospital Aintree NHS Fo
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81. IntroductionThe purpose of this
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venous shock, flare or phlebitis. S
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12Hyaluronidase: Dilute 1500 units
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scheme is co-ordinated through the
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16Appendix 2Specific antidotes in t
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experience. Due to the volume of th
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20G. Infiltrate the site with 1-3ml
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Collaborative Intravenous Nursing Service (CINS) Guidelines

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