Collaborative Intravenous Nursing Service (CINS) Guidelines

• Open out sterile pack to create a sterile field. Open remaining equipment ensuring nocontamination of sterile field. Pour out alcohol Chlorhexidine solution or openChlorhexidine impregnated applicator.• Loosen exit site dressing. To loosen dressing lift lower end and gently ease the dressingoff from the skin• Dressing should be removed from hand to elbow to prevent accidental catheterremoval. Be aware that fixation device may come off with the dressing.accessing intravenous catheter.To reduce incidence of infectionChlorhexidine based solutions arerecommended (in alcohol) as perpolicy (DOH 2001)46Aseptically remove the dressing.Wash hands and put on sterile glovesPlace sterile towel as near as possible to the catheter.Clean around the catheter and exit site with gauze soaked in 2% Chlorhexidine orChlorhexidine Gluconate 2% in 70% Isopropyl alcohol impregnated applicator.The solution should be applied with friction but should not be too vigorous or the skin'snatural defence may be destroyed.Allow to dry.Apply skin closure strips or skin fixation device, then apply highly permeable dressing toexit site.Remove the dressing towelRemove gloves.Clear away equipment. Dispose of contaminated waste as per policy. Remove apron.Decontaminate hands.Document care in patient’s records.To prevent accidental removal of thecatheter and friction or trauma to skinsurface.Alcoholic Chlorhexidine combines thebenefits of rapid action and excellentresidual activity (DOH 2001)Semi-permeable transparent IVdressings are well tolerated bypatients (Campbell et al 1999,Treston-Aurand et al 1997, Wille1993) and are easy to apply andremove (Wille 1997).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