Central Line Dressing Change Procedure

Preparation

• Verify Order and Check Need: Confirm the necessity of the procedure.
• Gather Supplies:
  • Central line dressing change kit
  • Extra sterile gloves
  • Extra masks
  • Blush
  • Any additional items needed for line changes

Initial Patient Interaction

• Hand Hygiene
• Introduce Self to Patient:
  • "Hi, my name is Brooke, and I'll be your nurse today."
  • Explain the procedure: Changing the central line dressing.
• Patient Verification:
  • Ask for name and DOB, compare with wristband.
  • Inquire about allergies (noting allergies to morphine and iodine).
• Explain Procedure and Privacy:
  • Assure the patient it’s painless.
  • Ensure patient's understanding and answer questions.
  • Wear masks to prevent microbial contamination.

Area and Equipment Preparation

• Lower side rails and raise bed for ergonomic working height.
• Position patient in semi-fowlers if comfortable.
• Hand Hygiene and Remove Jewelry: Ensure no contamination.
• Patient Mask and Head Turn: Have patient turn head to the side.

Site Inspection and Old Dressing Removal

• Inspect site, lumens, and arm for drainage or inflammation.
• Prepare garbage can for old dressing disposal.
• Remove old dressing starting from the bottom ("pants" first).
• Hand Hygiene Post-Dressing Removal

Setting Up the Sterile Field

• Open sterile kit and gloves using proper technique.
• Gloving: Ensure use of sterile gloves.

Cleaning and New Dressing Application

• Site Cleaning:

  • Use gauze and chlorhexidine.
  • Scrub insertion site, tubes, and surroundings.

• Let the area dry completely without fanning.

• Applying New Dressing:

  • Use dressing with a notch for lumens.
  • Center the insertion site and apply dressing from inside out.
  • Secure with additional pieces like "pants" and label with date.

Post-Procedure Checks

• Claves Inspection and Change:
  • Check and prepare to change claves.
  • Use alcohol swabs for cleaning before disconnecting old claves.
  • Ensure lumens are clamped during the process.
  • Connect new clave and flush line.

Finalizing Procedure

• Reposition the patient comfortably.
• Check on Patient's Comfort: Confirm no pain or discomfort.
• Document the procedure completion and any findings.