PLACE LABEL HERE

CENTRAL VENOUS CATHETER CARE

STANDINGORDERS

Nurse initiated standing order based on medical staff approved criteria/policy (500-64).

Orders with a “” are indicator choices and are NOT implemented unless checked. Initial the bottom of each page when indicated (multipage).

Type of
Central Venous Access / Dressing Change and
Frequency / Normal saline flush / Catheter Lock / Needleless connectors and Caps / Catheter Occlusion/ Sluggish Flow
 / NON-TUNNELED
Central venous catheter (CVC)
TUNNELED CVC
NON-TUNNELED
PICC
TUNNELED PICC /
  • Sterile, q 7 days and prn.
/
  • NS 5 ml prior to blood sampling
  • NS 10 ml or more before and after meds and fluids, including incompatible meds and fluids
  • NS 20 ml or more after viscous solutions, blood draw and transfusion
  • NS 10 ml q shift when not in use
/
  • Change needleless connectors q 7 days
  • Change passive-disinfection (green) caps with each use
/
  • Cathflo (activase)
2mg / 2ml
  • Instill 2mg per occluded lumen
  • May repeat x 1 if catheter remains occluded/sluggish after 120 minutes
  • Notify physician if occlusion persists after 2nd dose

 / IMPLANTED PORT /
  • Sterile, q 7 days and prn.
/
  • NS 5 ml prior to blood sampling
  • NS 10 ml or more before and after meds and fluids, including incompatible meds and fluids
  • NS 20 ml or more after viscous solutions, blood draw and transfusion
  • NS 10 ml q shift when not in use
/
  • Heparin 5 ml of 100 units/ml prior to deacces-sing & q 4 weeks for mainten-ance
/
  • Change non-coring needle q 7 days
  • Change needleless connector q 7 days
  • Change passive-disinfection (green) caps with each use
/
  • Cathflo (activase)
2mg / 2ml
  • Instill 2mg per occluded lumen
  • May repeat x 1 if catheter remains occluded/sluggish after 120 minutes
  • Notify physician if occlusion persists after 2nd dose

 / HEMODIALYSIS CATHETER
*only used by non- dialysis staff with order from nephrologist OR
in alife-threatening emergency /
  • Sterile, q 7 days and prn by dialysis nurse
  • If no HD, q 7 days
/
  • ALWAYS remove heparin from lumen by aspirating 3-5 ml from each lumen. DO NOT flush heparin through lumens.Do not remove needleless connector
  • NS 10 ml or more before and after meds and fluids, including incompatible meds and fluids
  • NS 20 ml or more after viscous solutions, blood draw and transfusion
/
  • Heparin 5,000 units/ml
  • IF allergic to Heparin or HIT positive, useSodium Citrate 4%
  • Instill fill volume of each lumen
DO NOT DILUTE with NS /
  • Change HD-specific needleless connectors q 7 days
  • Change passive-disinfection (white) caps with each use
/
  • Cathflo (activase)
2mg / 2ml
  • Instill 2mg per occluded lumen
  • May repeat x 1 if catheter remains occluded/sluggish after 120 minutes
  • Notify physician if occlusion persists after 2nd dose

______

Date TimeNurse SignaturePhysician Signature PID Number

Copy to pharmacy

*1-32657* FORM 1-32657 REV.07/2016 Page 1 of 1