Changing a Central Line Dressing of a Patient
Sample Central Line Dressing Checklist
| Critical Performance Elements | YES | NO | |
| 1. Gather all necessary equipment: roll of tape, label, and central line line dressing kit. | |||
| 2. Wash hands. Explain procedure to the patient and/or significant others. Check for providone-iodine or tape allergy. | |||
| 3. Organize supplies and equipment at bedside to decrease the amount of time that site is open to air. | |||
| 4. *** Open central line kit. Don mask. (Don gown if soiling is likely). | |||
| 5. Place patient in supine position with head turned away from catheter insertion site to decrease potential for contamination by patient’s secretions. Place a mask over the patient’s mouth and nose or sterile drape over ventilated or trached patient. | |||
| 6. *** Don a pair of clean gloves. | |||
| 7. Remove present dressing carefully to minimize trauma and prevent accidental dislodgment of catheter. Discard soiled dressing in proper trash receptacle. | |||
| 8. Visually inspect the skin and catheter site for signs of infection, leakage, or other mechanical problems. | |||
| 9. *** Remove soiled gloves and don sterile gloves. | |||
| 10. *** Working in a circular motion from insertion site outward to edge of dressing border cleanse skin, insertion site, and distal portion of catheter with :
a. Providone-iodine scrub swabsticks x 3 – to remove bacteria and fungi. b. Alcohol swabsticks x 3 – to remove the betadine scrub. c. Betadine solution swabsticks x 3 to cover a 3″ x 6″ area from site to periphery- to provide protective barrier against pathogens. Blot excess or pooled solution. Allow to dry. *** For patients with IODINE ALLERGY- If 4% chlorhexidine is used, remove it with alcohol swabs after a two to five minute dwell time. |
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| 11. If a tubing change is necessary:
a. Instruct the patient to perform Valsalva maneuver or hold his/her breath (or immediately after a ventilator delivers a breath). b. Quickly disconnect and reconnect the IV tubing ensuring secure junction. |
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| 12. *** Dressing- may use elastoplast or occlusive dressing as follows:
a. Elastoplast:
b. Occlusive Dressing- (Tegaderm):
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| 13. *** Loop and secure IV tubing to dressing and arm or chest. | |||
| 14. *** Label dressing with time, date of dressing change and insertion, and initials. | |||
| 15. Discard supplies used. Wash hands. | |||
| 17. *** Document the dressing change, the condition of the insertion site on nursing note and flow sheet. Document any problems encountered in nursing progress notes on. | |||
| NOTE: If 2×2 gauze used after initial insertion under occlusive (Tegaderm) dressing, dressing must be changed in 24 hours. | |||
*** Must perform these critical elements for successful completion.
REFERENCE: Infection Control Manual
